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General NPI Number Information
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NPI Number | 1568636041
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Entity Type | Organization
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Legal Business Name | RICHARD J. MCNULTY,D.M.D.,P.C.
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Dates
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Enumeration Date | 04/16/2008
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | 310 WASHINTON ST. #208
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City | WELLESLEY
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State | MA
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Zip | 02481-0000
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Country | US
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Telephone | 781-263-9900
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Fax |
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Provider Business Mailing Address
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Address Line | 310 WASHINGTON ST STE 208
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City | WELLESLEY
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State | MA
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Zip | 02481-4949
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Country | US
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Telephone | 781-263-9900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/DENTIST
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Name | DR. RICHARD JOHN MCNULTY SR.
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Credential | D.M.D.
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Telephone | 781-263-9900
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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 | 14347
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License Number State | MA
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