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General NPI Number Information
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NPI Number | 1770755654
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Entity Type | Organization
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Legal Business Name | BEYOND YOUR SMILE, PC
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Dates
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Enumeration Date | 03/31/2008
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Last Update Date | 10/10/2019
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Provider Practice Location Address
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Address Line | 254 COCHITUATE RD
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City | FRAMINGHAM
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State | MA
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Zip | 01701-4627
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Country | US
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Telephone | 508-875-1060
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Fax | 508-875-0620
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Provider Business Mailing Address
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Address Line | 254 COCHITUATE RD
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City | FRAMINGHAM
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State | MA
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Zip | 01701-4627
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Country | US
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Telephone | 508-875-1060
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Fax | 508-875-0620
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. SUE LEE
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Credential | DMD
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Telephone | 508-875-1060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 18131
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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