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NPI Code Detail

MEDICARE: DR. NICHOLAS JOSEPH DIMAURO D.D.S.

MEDICARE: DR. NICHOLAS JOSEPH DIMAURO D.D.S.
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 Dentistry17035MA

General Provider Information

NPI Number : 1972581023
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICHOLAS JOSEPH DIMAURO D.D.S.
Provider Business Mailing Address
First Line : 100 S MAIN ST
Second Line : SUITE 100 B
City : MIDDLETON
State : MA
Zip : 01949-2211
Country : US
Telephone Number : 978-777-8722
Fax Number : 978-777-9223
Provider Business Practice Location Address
First Line : 100 S MAIN ST
Second Line : SUITE 100 B
City : MIDDLETON
State : MA
Zip : 01949-2211
Country : US
Telephone Number : 978-777-8722
Fax Number : 978-777-9223
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2006
Last Update Date : 07/08/2007

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