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General NPI Number Information
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NPI Number | 1164589867
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Entity Type | Organization
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Legal Business Name | STUART CUSHNER, D.M.D.,P.C.
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 10/10/2007
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Provider Practice Location Address
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Address Line | 2 KNOTTY WALK
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City | TAUNTON
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State | MA
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Zip | 02780-3249
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Country | US
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Telephone | 508-824-8030
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Fax |
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Provider Business Mailing Address
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Address Line | 2 KNOTTY WALK PO BOX 2791
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City | TAUNTON
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State | MA
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Zip | 02780-3249
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Country | US
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Telephone | 508-824-8030
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST OWNER
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Name | DR. STUART CUSHNER
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Credential | DMD PC
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Telephone | 508-824-8030
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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 | 15314
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License Number State | MA
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