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General NPI Number Information
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NPI Number | 1700949385
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Entity Type | Organization
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Legal Business Name | PHILIP A STRUZZIERO
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 575 WASHINGTON ST SUITE 152
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City | BRAINTREE
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State | MA
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Zip | 02184-5620
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Country | US
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Telephone | 781-356-8111
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Fax | 781-356-9036
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Provider Business Mailing Address
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Address Line | 575 WASHINGTON ST SUITE 152
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City | BRAINTREE
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State | MA
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Zip | 02184-5620
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Country | US
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Telephone | 781-356-8111
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Fax | 781-356-9036
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Authorized Official
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Title or Position | OWNER
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Name | PHILIP A STRUZZIERO
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Credential | DMD
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Telephone | 781-356-8111
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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 | DN129181
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License Number State | MA
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