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General NPI Number Information
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NPI Number | 1316586548
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Entity Type | Organization
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Legal Business Name | HINGHAM SHIPYARD FAMILY DENTAL
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Dates
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Enumeration Date | 01/06/2020
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Last Update Date | 01/06/2020
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Provider Practice Location Address
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Address Line | 350 LINCOLN ST STE 1106
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City | HINGHAM
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State | MA
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Zip | 02043-1579
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Country | US
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Telephone | 781-749-7888
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Fax | 781-749-9888
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Provider Business Mailing Address
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Address Line | 350 LINCOLN ST STE 1106
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City | HINGHAM
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State | MA
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Zip | 02043-1579
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Country | US
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Telephone | 781-749-7888
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Fax | 781-749-9888
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Authorized Official
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Title or Position | MEMBER/OWNER
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Name | DR. CRISTIAN TUDOR
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Credential | DMD
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Telephone | 857-294-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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