Healthcare Provider Details

I. General information

NPI: 1700965746
Provider Name (Legal Business Name): JOYCE JOHNSTON-NEESER DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 05/28/2021
Certification Date: 05/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 MAIN ST STE 5
HUDSON MA
01749-2320
US

IV. Provider business mailing address

241 MAIN ST STE 5
HUDSON MA
01749-2320
US

V. Phone/Fax

Practice location:
  • Phone: 782-125-8429
  • Fax: 978-212-5843
Mailing address:
  • Phone: 978-212-5842
  • Fax: 978-212-5843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number19499
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: