=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851469555
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DEXTERITY SURGICAL, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/01/2006
-----------------------------------------------------
Last Update Date | 08/05/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 UNICORN PARK DRIVE SUITE 102
-----------------------------------------------------
City | WOBURN
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-721-0500
-----------------------------------------------------
Fax | 781-721-5719
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 UNICORN PARK DRIVE SUITE 102
-----------------------------------------------------
City | WOBURN
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-721-0500
-----------------------------------------------------
Fax | 781-721-5719
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COOWNER
-----------------------------------------------------
Name | DR. VIRGINIA S HUNG
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 781-721-0500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 218005
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2082S0105X
-----------------------------------------------------
Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 208200000X
-----------------------------------------------------
Taxonomy Name | Plastic Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------