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General NPI Number Information
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NPI Number | 1164744355
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Entity Type | Organization
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Legal Business Name | BARONE AND COGNATA DMD PC
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Dates
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Enumeration Date | 02/16/2010
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Last Update Date | 02/16/2010
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Provider Practice Location Address
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Address Line | 599 BROADWAY
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City | EVERETT
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State | MA
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Zip | 02149-3712
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Country | US
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Telephone | 617-389-1516
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Fax |
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Provider Business Mailing Address
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Address Line | 210 HUMPHREY ST
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City | MARBLEHEAD
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State | MA
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Zip | 01945-1665
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL J COGNATA
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Credential | DMD
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Telephone | 617-389-1516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 13926
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License Number State | MA
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