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NPI Code Detail

MEDICARE: DENTAL ASSOICATES OF GLOUCESTER, LLC

MEDICARE: DENTAL ASSOICATES OF GLOUCESTER, LLC
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
11223G0001XGeneral Practice Dentistry12116MA
21223G0001XGeneral Practice Dentistry20806MA

General Provider Information

NPI Number : 1053342972
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTAL ASSOICATES OF GLOUCESTER, LLC
Provider Business Mailing Address
First Line : 321 WASHINGTON ST
Second Line :
City : GLOUCESTER
State : MA
Zip : 01930-4837
Country : US
Telephone Number : 978-281-1337
Fax Number : 978-281-7573
Provider Business Practice Location Address
First Line : 321 WASHINGTON ST
Second Line :
City : GLOUCESTER
State : MA
Zip : 01930-4837
Country : US
Telephone Number : 978-281-1337
Fax Number : 978-281-7573
Authorized Official
Title or Position : PARTNER
Name : DR. ROBERT ANTHONY RUSSO
Credential : D.M.D.
Telephone Number : 978-281-1337
Provider Enumeration Date : 07/06/2006
Last Update Date : 08/22/2020

Similar Medicare Providers

1891720066 — DR. ROBERT ANTHONY RUSSO D.M.D.
Practice Location Address:
321 WASHINGTON ST
GLOUCESTER, MA
01930-4837
Practice Phone: 978-281-1337
Practice Fax: 978-281-7573
1649340373 — SPENCER FAMILY CHIROPRACTIC, P.C.
Practice Location Address:
321 WASHINGTON ST
GLOUCESTER, MA
01930-4837
Practice Phone: 978-281-1411
Practice Fax: 978-281-2727
1861562589 — DR. NATHAN SPENCER D.C.
Practice Location Address:
321 WASHINGTON ST
GLOUCESTER, MA
01930-4837
Practice Phone: 978-281-1411
Practice Fax: 978-281-2727
1770438608 — KATELYN ROSE HINCKLEY
Practice Location Address:
3 HINCKLEY RD
GLOUCESTER, MA
01930-3201
Practice Phone: 978-559-1461
Practice Fax:
1033112966 — DR. JUDITH MONTEFERRANTE MD
Practice Location Address:
45 EASTERN POINT RD
GLOUCESTER, MA
01930-4139
Practice Phone: 978-283-6856
Practice Fax: 978-282-0977
1245231059 — DR. MATTHEW WILLIAM WEINSTEIN-ZANGER M.D.
Practice Location Address:
35 MIDDLE ST
GLOUCESTER, MA
01930-5715
Practice Phone: 978-281-0600
Practice Fax: 978-283-4516

Directions to “DENTAL ASSOICATES OF GLOUCESTER, LLC ” Practice Location

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