Healthcare Provider Details

I. General information

NPI: 1285055095
Provider Name (Legal Business Name): OGILVIE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2013
Last Update Date: 12/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 BAXTERS NECK RD
MARSTONS MILLS MA
02648-1813
US

IV. Provider business mailing address

1928 THATCH PALM DR
BOCA RATON FL
33432-7457
US

V. Phone/Fax

Practice location:
  • Phone: 561-866-6142
  • Fax:
Mailing address:
  • Phone: 561-866-6142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN12896
License Number StateMA

VIII. Authorized Official

Name: DR. BARRY ALAN LEHMAN
Title or Position: OWNER
Credential: DDS
Phone: 561-866-6142