Healthcare Provider Details

I. General information

NPI: 1902304637
Provider Name (Legal Business Name): GEORGE HATZIGIANNIS DMD MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2018
Last Update Date: 01/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 OSGOOD ST
NORTH ANDOVER MA
01845-1500
US

IV. Provider business mailing address

48 REGENCY PLACE
NORTH ANDOVER MA
01845
US

V. Phone/Fax

Practice location:
  • Phone: 978-317-3604
  • Fax:
Mailing address:
  • Phone: 978-317-3604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number21814
License Number StateMA

VIII. Authorized Official

Name: DR. GEORGE PARASKEVAS HATZIGIANNIS
Title or Position: OWNER
Credential: DMD, MD
Phone: 978-317-3604