MEDICARE: PAUL G. LOMBARDO, DMD, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center	18006	MA

General Provider Information

NPI Number	:	1013308956
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAUL G. LOMBARDO, DMD, PC

Provider Business Mailing Address
First Line	:	104 WINN ST
Second Line	:
City	:	BURLINGTON
State	:	MA
Zip	:	01803-3101
Country	:	US
Telephone Number	:	781-272-1150
Fax Number	:	781-272-6170

Provider Business Practice Location Address
First Line	:	104 WINN ST
Second Line	:
City	:	BURLINGTON
State	:	MA
Zip	:	01803-3101
Country	:	US
Telephone Number	:	781-272-1150
Fax Number	:	781-272-6170

Authorized Official
Title or Position	:	OWNER
Name	:	DR. PAUL GERARD LOMBARDO
Credential	:	DMD
Telephone Number	:	781-272-1150

Provider Enumeration Date	:	02/13/2015
Last Update Date	:	02/13/2015

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