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General NPI Number Information
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NPI Number | 1982741955
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Entity Type | Individual
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Provider Name | KRISTINE ACHILLE GRAZIOSO DMD
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Gender | Female
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 223 CHIEF JUSTICE CUSHING HWY SUITE 102
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City | COHASSET
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State | MA
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Zip | 02025-1391
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Country | US
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Telephone | 781-383-0003
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Fax | 781-383-0032
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Provider Business Mailing Address
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Address Line | 66 EMERY RD
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City | MARSHFIELD
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State | MA
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Zip | 02050-4415
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Country | US
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Telephone | 781-834-8635
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 18935
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License Number State | MA
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