| Dental Surgeons Of Fall River, Pc | |
|
180 Elsbree St Fall River MA 02720-7212 | |
| (508) 672-1069 | |
| (508) 672-3848 |
| Full Name | Dental Surgeons Of Fall River, Pc |
|---|---|
| Speciality | Dentist |
| Location | 180 Elsbree St, Fall River, Massachusetts |
| Authorized Official Name and Position | John A Marshall (OWNER) |
| Authorized Official Contact | 5086721069 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Surgeons Of Fall River, Pc 180 Elsbree St Fall River MA 02720-7212 Ph: (508) 672-1069 | Dental Surgeons Of Fall River, Pc 180 Elsbree St Fall River MA 02720-7212 Ph: (508) 672-1069 |
| NPI Number | 1609886720 |
|---|---|
| Provider Enumeration Date | 08/09/2006 |
| Last Update Date | 01/26/2015 |
| Medicare PECOS PAC ID | 2567469018 |
|---|---|
| Medicare Enrollment ID | O20061026000276 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609886720 | NPI | - | NPPES |
| X11833 | Other | MA | BCBS MA |
| X12118 | Other | MA | BCBS MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | 18730 (Massachusetts) | Primary |
| Provider Name | John A Marshall |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1154331395 PECOS PAC ID: 1658370481 Enrollment ID: I20061205000459 |
| Provider Name | Mark J Milano |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1265442321 PECOS PAC ID: 3779552880 Enrollment ID: I20070106000136 |
| Provider Name | Nicholas S. Kim |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1457994980 PECOS PAC ID: 9830523927 Enrollment ID: I20230724002225 |
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