=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003761784
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TMJ & SLEEP THERAPY CENTRE OF NEW ENGLAND
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2026
-----------------------------------------------------
Last Update Date | 02/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 563 MAIN ST
-----------------------------------------------------
City | BOLTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01740-1300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-779-0865
-----------------------------------------------------
Fax | 978-779-6023
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 563 MAIN ST
-----------------------------------------------------
City | BOLTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01740-1300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-779-0865
-----------------------------------------------------
Fax | 978-779-6023
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER DENTIST
-----------------------------------------------------
Name | DR. AMPARO DAVID
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 978-779-2888
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223X2210X
-----------------------------------------------------
Taxonomy Name | Orofacial Pain Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------