MEDICARE: FRANK W WETHERBEE JR. DMD

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	1223G0001X	General Practice Dentistry	12178	MA

General Provider Information

NPI Number	:	1871736389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANK W WETHERBEE JR. DMD

Provider Business Mailing Address
First Line	:	27 SETON HIGHLANDS
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-2543
Country	:	US
Telephone Number	:	978-807-8479
Fax Number	:

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	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2009
Last Update Date	:	04/14/2009

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