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General NPI Number Information
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NPI Number | 1053097089
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Entity Type | Individual
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Provider Name | MRS. LYNDA M BERNASCONI
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Gender | Female
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Dates
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Enumeration Date | 06/26/2023
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 4 KEITH WAY STE 3
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City | HINGHAM
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State | MA
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Zip | 02043-4258
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Country | US
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Telephone | 781-267-7627
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Fax |
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Provider Business Mailing Address
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Address Line | 90 TENNEY RD
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City | BRAINTREE
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State | MA
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Zip | 02184-6532
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Country | US
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Telephone | 781-354-6945
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH10655
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License Number State | MA
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