Healthcare Provider Details

I. General information

NPI: 1952897589
Provider Name (Legal Business Name): DENTISTS OF HANOVER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2018
Last Update Date: 06/14/2022
Certification Date: 06/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 WASHINGTON ST STE 3&4
HANOVER MA
02339-1648
US

IV. Provider business mailing address

PO BOX 920050
DALLAS TX
75392-0050
US

V. Phone/Fax

Practice location:
  • Phone: 508-499-8435
  • Fax:
Mailing address:
  • Phone: 714-845-8280
  • Fax: 303-952-0892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. FREDERICK H. LEE
Title or Position: OWNER/DMD
Credential: DMD
Phone: 508-499-8435