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General NPI Number Information
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NPI Number | 1720905318
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Entity Type | Organization
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Legal Business Name | SYNERGY PRACTICE GROUP PLLC
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Dates
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Enumeration Date | 07/02/2026
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Last Update Date | 07/02/2026
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Provider Practice Location Address
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Address Line | 55 NORTH RD STE 225
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City | BEDFORD
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State | MA
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Zip | 01730-1078
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Country | US
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Telephone | 781-275-5766
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Fax |
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Provider Business Mailing Address
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Address Line | 84 MOSHER LN
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City | MARLBOROUGH
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State | MA
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Zip | 01752-5650
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Country | US
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Telephone | 508-410-8437
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Fax |
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Authorized Official
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Title or Position | OWNER/ PROVIDER
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Name | IRIS ANASTASIA PANOS
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Credential | DMD
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Telephone | 508-410-8437
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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 |
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License Number State |
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