=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720967516
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EASTON DENTAL SPECIALISTS GPS PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/27/2025
-----------------------------------------------------
Last Update Date | 08/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 855 WASHINGTON ST
-----------------------------------------------------
City | SOUTH EASTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02375-1133
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-230-3737
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 855 WASHINGTON ST
-----------------------------------------------------
City | SOUTH EASTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02375-1133
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | HUNTER SMITH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 508-230-3737
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------