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General NPI Number Information
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NPI Number | 1851015564
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Entity Type | Organization
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Legal Business Name | WATERTOWN DENTAL ASSOCIATES PLLC
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Dates
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Enumeration Date | 09/27/2022
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Last Update Date | 11/28/2022
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Provider Practice Location Address
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Address Line | 1 INTERNATIONAL PL FL 7
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City | BOSTON
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State | MA
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Zip | 02110-2602
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Country | US
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Telephone | 617-330-8887
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Fax |
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Provider Business Mailing Address
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Address Line | 1 INTERNATIONAL PL FL 7
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City | BOSTON
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State | MA
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Zip | 02110-2602
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Country | US
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Telephone | 617-330-8887
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NICHOLAS THEODORE PAPAPETROS
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Credential | DMD
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Telephone | 978-886-2678
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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 |
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License Number State |
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