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General NPI Number Information
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NPI Number | 1548327604
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Entity Type | Individual
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Provider Name | ROBERT LINDSAY MANDELL D.M. D. , M.M.SC.
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Gender | Male
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Dates
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Enumeration Date | 01/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 164 WESTFORD RD SUITE 8
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City | TYNGSBORO
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State | MA
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Zip | 01879-2530
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Country | US
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Telephone | 978-649-3058
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Fax | 978-649-9566
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Provider Business Mailing Address
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Address Line | 441 LOWELL ST
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City | READING
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State | MA
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Zip | 01867-1533
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Country | US
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Telephone | 781-942-0190
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Fax | 781-944-5258
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 13306
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License Number State | MA
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