| Brockton Oral & Maxillofacial Surgery Inc | |
|
1351 Main St Brockton MA 02301 | |
| (508) 587-2000 | |
| (508) 580-3552 |
| Full Name | Brockton Oral & Maxillofacial Surgery Inc |
|---|---|
| Speciality | Dentist |
| Location | 1351 Main St, Brockton, Massachusetts |
| Authorized Official Name and Position | Paul M Fitzgerald (PRESIDENT) |
| Authorized Official Contact | 5085872000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brockton Oral & Maxillofacial Surgery Inc 1351 Main St Brockton MA 02301 Ph: (508) 587-2000 | Brockton Oral & Maxillofacial Surgery Inc 1351 Main St Brockton MA 02301 Ph: (508) 587-2000 |
| NPI Number | 1457370504 |
|---|---|
| Provider Enumeration Date | 07/19/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7315002300 |
|---|---|
| Medicare Enrollment ID | O20090206000280 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457370504 | NPI | - | NPPES |
| X10443 | Other | MA | BCBS |
| 9774521 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 16545 (Massachusetts) | Primary |
| Provider Name | Joseph A Marino |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1740235431 PECOS PAC ID: 9638215650 Enrollment ID: I20091006000182 |
| Provider Name | Sung Kiang Chuang |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1326154865 PECOS PAC ID: 5294916235 Enrollment ID: I20110223000685 |
Jnel Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 715 Crescent St, Brockton, MA 02302 Phone: 508-895-9100 | |
Massasoit Dental Associates Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 288 Belmont Street, Brockton, MA 02301 Phone: 508-583-0103 Fax: 508-583-0140 | |
Drs Celli And Fields Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 185 Belmont Street, Brockton, MA 02301 Phone: 508-586-2668 Fax: 508-586-8332 | |
Matthew Manzi Dmd Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 288 Belmont St, Brockton, MA 02301 Phone: 508-583-0103 | |
Premier Dentistry, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 348 N Pearl St, Brockton, MA 02301 Phone: 508-584-6070 | |
Adventure Dental Of Brockton Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 21torrey, Brockton, MA 02301 Phone: 719-576-1850 Fax: 719-576-1929 | |
Rahul Malik Dmd Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 Pleasant St, Brockton, MA 02301 Phone: 205-639-7259 |