Healthcare Provider Details

I. General information

NPI: 1609322452
Provider Name (Legal Business Name): LOWELL ORAL SURGERY ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 NORTH RD 2ND FLOOR
CHELMSFORD MA
01824-2722
US

IV. Provider business mailing address

26 NORTH RD 2ND FLOOR
CHELMSFORD MA
01824-2722
US

V. Phone/Fax

Practice location:
  • Phone: 978-328-0432
  • Fax:
Mailing address:
  • Phone: 978-328-0432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA L YOUNG
Title or Position: CEO
Credential: MBA, FACMPE
Phone: 978-458-1264