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General NPI Number Information
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NPI Number | 1275577058
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Entity Type | Organization
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Legal Business Name | HILZENRATH AND LEVINE ORTHODONTICS, LLC
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 21A MUZZEY ST
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City | LEXINGTON
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State | MA
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Zip | 02421-5202
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Country | US
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Telephone | 781-860-9473
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Fax |
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Provider Business Mailing Address
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Address Line | 21A MUZZEY ST
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City | LEXINGTON
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State | MA
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Zip | 02421-5202
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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 | DOCTOR
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Name | DR. SAM LEVINE
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Credential | DDS, MS
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Telephone | 781-860-9473
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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 | 21310
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License Number State | MA
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