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General NPI Number Information
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NPI Number | 1073239703
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Entity Type | Organization
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Legal Business Name | KIDS AIRWAY DENTIST, P.C.
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Dates
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Enumeration Date | 10/14/2022
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Last Update Date | 10/14/2022
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Provider Practice Location Address
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Address Line | 7 GRAF RD STE 2A
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City | NEWBURYPORT
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State | MA
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Zip | 01950-4078
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Country | US
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Telephone | 978-462-2227
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Fax | 978-462-4343
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Provider Business Mailing Address
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Address Line | 5 HARWICH LN
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City | ANDOVER
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State | MA
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Zip | 01810-5043
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Country | US
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Telephone | 617-276-5439
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | DR. LINDI J EZEKOWITZ
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Credential | D.D.S.
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Telephone | 978-462-2227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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