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General NPI Number Information
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NPI Number | 1083044606
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Entity Type | Organization
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Legal Business Name | JOSEPH A. MENNA, D.M.D. INC.
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Dates
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Enumeration Date | 11/18/2013
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Last Update Date | 11/18/2013
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Provider Practice Location Address
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Address Line | 169 W MAIN ST
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City | HOPKINTON
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State | MA
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Zip | 01748-2175
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Country | US
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Telephone | 508-435-9391
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Fax | 508-435-2073
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Provider Business Mailing Address
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Address Line | 169 W MAIN ST
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City | HOPKINTON
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State | MA
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Zip | 01748-2175
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Country | US
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Telephone | 508-435-9391
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Fax | 508-435-2073
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. JOSEPH A MENNA
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Credential |
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Telephone | 508-435-9391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 15589
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License Number State | MA
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