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General NPI Number Information
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NPI Number | 1336283019
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Entity Type | Organization
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Legal Business Name | MASS ORAL SURGERY, PC
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 09/06/2026
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Provider Practice Location Address
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Address Line | 1 WALPOLE ST
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City | NORWOOD
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State | MA
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Zip | 02062-3315
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Country | US
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Telephone | 781-762-7077
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Fax | 781-762-4398
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Provider Business Mailing Address
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Address Line | 1 WALPOLE ST
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City | NORWOOD
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State | MA
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Zip | 02062-3315
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Country | US
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Telephone | 781-762-7077
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Fax | 781-762-4398
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Authorized Official
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Title or Position | VP, PAYOR RELATIONS
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Name | MICHAELA MUNIZ
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Credential |
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Telephone | 469-324-3242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 14463
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License Number State | MA
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