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General NPI Number Information
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NPI Number | 1710475546
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Entity Type | Organization
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Legal Business Name | PLYMOUTH ORTHODONTICS
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Dates
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Enumeration Date | 04/26/2018
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Last Update Date | 04/26/2018
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Provider Practice Location Address
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Address Line | 51 LONG POND RD
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City | PLYMOUTH
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State | MA
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Zip | 02360-2670
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Country | US
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Telephone | 508-815-1695
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Fax | 833-427-3280
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Provider Business Mailing Address
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Address Line | 51 LONG POND RD
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City | PLYMOUTH
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State | MA
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Zip | 02360-2670
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Country | US
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Telephone | 508-815-1695
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Fax | 833-427-3280
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. KARLA M ALVARADO
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Credential | DMD, MSD
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Telephone | 508-815-1695
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 1857505
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License Number State | MA
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