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General NPI Number Information
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NPI Number | 1194214742
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Entity Type | Organization
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Legal Business Name | NORWOOD DENTAL SLEEP MEDICINE LLC
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Dates
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Enumeration Date | 05/08/2018
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Last Update Date | 05/08/2018
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Provider Practice Location Address
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Address Line | 100 DAY ST
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City | NORWOOD
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State | MA
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Zip | 02062-2125
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Country | US
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Telephone | 781-352-8497
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Fax | 781-352-8498
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Provider Business Mailing Address
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Address Line | 100 DAY ST
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City | NORWOOD
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State | MA
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Zip | 02062-2125
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Country | US
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Telephone | 781-352-8497
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Fax | 781-352-8498
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT WHITTIER STODDARD
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Credential | DMD
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Telephone | 781-352-8497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 16793
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License Number State | MA
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