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NPI Code Detail

MEDICARE: LOWELL DENTISTRY AND BRACES, PC

MEDICARE: LOWELL DENTISTRY AND BRACES, 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
1122300000XDentist

General Provider Information

NPI Number : 1881308310
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOWELL DENTISTRY AND BRACES, PC
Provider Business Mailing Address
First Line : 5 MOUNT ROYAL AVE STE 300
Second Line :
City : MARLBOROUGH
State : MA
Zip : 01752-1900
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1201 BRIDGE ST
Second Line :
City : LOWELL
State : MA
Zip : 01850-1293
Country : US
Telephone Number : 978-455-7056
Fax Number :
Authorized Official
Title or Position : CHIEF REVENUE OFFICER
Name : TODD PACHELLO
Credential :
Telephone Number : 720-475-6482
Provider Enumeration Date : 01/10/2023
Last Update Date : 03/11/2026

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