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General NPI Number Information
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NPI Number | 1396025441
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Entity Type | Organization
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Legal Business Name | INFANTE & GOMEZ PC
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Dates
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Enumeration Date | 08/22/2011
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Last Update Date | 04/13/2017
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Provider Practice Location Address
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Address Line | 29 HUDSON RD 3220
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City | SUDBURY
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State | MA
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Zip | 01776-1747
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Country | US
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Telephone | 978-443-4545
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Fax |
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Provider Business Mailing Address
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Address Line | 29 HUDSON RD 3220
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City | SUDBURY
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State | MA
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Zip | 01776-1747
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Country | US
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Telephone | 978-443-4545
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Fax |
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Authorized Official
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Title or Position | P
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Name | DR. GUSTAVO J INFANTE
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Credential | DMD
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Telephone | 617-645-3286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN21546
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | DN21117
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License Number State | MA
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