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General NPI Number Information
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NPI Number | 1447385208
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Entity Type | Individual
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Provider Name | RONALD PAUL HERSEY D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1150 WASHINGTON ST
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City | BRAINTREE
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State | MA
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Zip | 02184-5440
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Country | US
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Telephone | 781-848-4737
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Fax |
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Provider Business Mailing Address
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Address Line | 1 BEECH RD
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City | AVON
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State | MA
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Zip | 02322-1806
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Country | US
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Telephone | 508-583-1192
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 18915
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License Number State | MA
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