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NPI Code Detail

MEDICARE: CRANBERRY DENTAL ASSOCIATES, INC.

MEDICARE: CRANBERRY DENTAL ASSOCIATES, INC.
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 Dentistry

General Provider Information

NPI Number : 1508005448
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRANBERRY DENTAL ASSOCIATES, INC.
Provider Business Mailing Address
First Line : 70 N MAIN ST
Second Line :
City : CARVER
State : MA
Zip : 02330-1128
Country : US
Telephone Number : 508-866-3800
Fax Number : 508-866-3811
Provider Business Practice Location Address
First Line : 70 N MAIN ST
Second Line :
City : CARVER
State : MA
Zip : 02330-1128
Country : US
Telephone Number : 508-866-3800
Fax Number : 508-866-3811
Authorized Official
Title or Position : PRESIDENT
Name : MR. ROBERT PAUL HEGNER
Credential :
Telephone Number : 617-699-1007
Provider Enumeration Date : 02/17/2009
Last Update Date : 02/17/2009

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Directions to “CRANBERRY DENTAL ASSOCIATES, INC. ” Practice Location

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