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NPI Code Detail

MEDICARE: CONCORD ORTHODONTICS PLLC

MEDICARE: CONCORD ORTHODONTICS PLLC
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
11223X0400XOrthodontics and Dentofacial Orthopedics DentistryDN1856042MA

General Provider Information

NPI Number : 1427588763
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONCORD ORTHODONTICS PLLC
Provider Business Mailing Address
First Line : 1732 MAIN ST STE C1-A
Second Line :
City : CONCORD
State : MA
Zip : 01742-3837
Country : US
Telephone Number : 978-342-8586
Fax Number :
Provider Business Practice Location Address
First Line : 1732 MAIN ST STE C1-A
Second Line :
City : CONCORD
State : MA
Zip : 01742-3837
Country : US
Telephone Number : 978-342-8586
Fax Number :
Authorized Official
Title or Position : OWNER/ORTHODONTIST
Name : DR. YANG LI
Credential : DMD, MSCD, CAGS
Telephone Number : 415-707-9216
Provider Enumeration Date : 06/19/2017
Last Update Date : 07/21/2022

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Directions to “CONCORD ORTHODONTICS PLLC ” Practice Location

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