Healthcare Provider Details

I. General information

NPI: 1649449794
Provider Name (Legal Business Name): FAMILY ORTHODONTICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2008
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 E MAIN ST SUITE #108
WESTBOROUGH MA
01581-1464
US

IV. Provider business mailing address

57 E MAIN ST SUITE #108
WESTBOROUGH MA
01581-1464
US

V. Phone/Fax

Practice location:
  • Phone: 508-366-7976
  • Fax: 508-366-7876
Mailing address:
  • Phone: 508-366-7976
  • Fax: 508-366-7876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number20209
License Number StateMA

VIII. Authorized Official

Name: TODD PACHELLO
Title or Position: PRESIDENT CHIEF REVENUE OFFICER
Credential: DMD, MMSC
Phone: 720-475-6482