| Boutselis Family Dental Care Pc | |
|
381r Main Street Tewksbury MA 01876 | |
| (978) 640-1114 | |
| (978) 640-1117 |
| Full Name | Boutselis Family Dental Care Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 381r Main Street, Tewksbury, Massachusetts |
| Authorized Official Name and Position | George Alexander Boutselis (OWNER PRESIDENT) |
| Authorized Official Contact | 9786401114 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boutselis Family Dental Care Pc 381r Main Street Tewksbury MA 01876 Ph: (978) 640-1114 | Boutselis Family Dental Care Pc 381r Main Street Tewksbury MA 01876 Ph: (978) 640-1114 |
| NPI Number | 1457423154 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457423154 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 11196 (Massachusetts) | Primary |
| 1223G0001X | Dentist - General Practice | 18573 (Massachusetts) | Secondary |
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