Healthcare Provider Details

I. General information

NPI: 1386719334
Provider Name (Legal Business Name): HINGHAM ENDODONTICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 12/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 WHITING STREET SUITE 2
HINGHAM MA
02043
US

IV. Provider business mailing address

210 WHITING STREET SUITE 2
HINGHAM MA
02043
US

V. Phone/Fax

Practice location:
  • Phone: 781-749-1119
  • Fax: 781-740-8033
Mailing address:
  • Phone: 781-749-1119
  • Fax: 781-740-8033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number10601
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number16403
License Number StateMA

VIII. Authorized Official

Name: DR. JOHN VINCENT DOLBEC
Title or Position: PRESIDENT
Credential: DDS
Phone: 781-749-1119