| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 61 Main St, Stoneham, Massachusetts |
| Authorized Official Name and Position | Jonathan Chase (PRESIDENT) |
| Authorized Official Contact | 7814382100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
61 Main St Stoneham MA 02180-3364 Ph: (781) 438-2100 | 61 Main St Stoneham MA 02180-3364 Ph: (781) 438-2100 |
| NPI Number | 1457421091 |
|---|---|
| Provider Enumeration Date | 11/09/2006 |
| Last Update Date | 09/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457421091 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 17009 (Massachusetts) | Primary |
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