Healthcare Provider Details

I. General information

NPI: 1558392431
Provider Name (Legal Business Name): PETER DROB DMD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 PLEASANT ST
WORCESTER MA
01609
US

IV. Provider business mailing address

475 PLEASANT ST
WORCESTER MA
01609
US

V. Phone/Fax

Practice location:
  • Phone: 508-756-7121
  • Fax: 508-756-0973
Mailing address:
  • Phone: 508-756-7121
  • Fax: 508-756-0973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number10053
License Number StateMA

VIII. Authorized Official

Name: DR. PETER L DROB
Title or Position: PRESIDENT
Credential: DMD
Phone: 508-756-7121