| Merrimack Valley Oral Surgeons, Inc | |
|
88 Montvale Ave Ste 5 Stoneham MA 02180-3643 | |
| (781) 438-7206 | |
| (781) 279-9029 |
| Full Name | Merrimack Valley Oral Surgeons, Inc |
|---|---|
| Speciality | Dentist |
| Location | 88 Montvale Ave, Stoneham, Massachusetts |
| Authorized Official Name and Position | Kate Ackermann (OFFICE MANAGER) |
| Authorized Official Contact | 7814387206 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Merrimack Valley Oral Surgeons, Inc 88 Montvale Ave Ste 5 Stoneham MA 02180-3643 Ph: (781) 438-7206 | Merrimack Valley Oral Surgeons, Inc 88 Montvale Ave Ste 5 Stoneham MA 02180-3643 Ph: (781) 438-7206 |
| NPI Number | 1356460810 |
|---|---|
| Provider Enumeration Date | 03/28/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6901969401 |
|---|---|
| Medicare Enrollment ID | O20090109000269 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356460810 | NPI | - | NPPES |
| 9774459 | Medicaid | MA | |
| 702431B | Other | MA | TUFTS |
| X10741 | Other | MA | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Hamid Esbah Tabatabaie |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1265495709 PECOS PAC ID: 1052474558 Enrollment ID: I20090109000307 |
| Provider Name | Allen W Tarro |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1851438295 PECOS PAC ID: 5991869547 Enrollment ID: I20111018000149 |
| Provider Name | Neil S Hornung |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1972566412 PECOS PAC ID: 9537223185 Enrollment ID: I20120322000719 |
| Provider Name | Sajal Swaroop |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1548600216 PECOS PAC ID: 8325318595 Enrollment ID: I20170720001157 |
| Provider Name | Mark A. Green |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1821352394 PECOS PAC ID: 1254585342 Enrollment ID: I20180529001418 |
| Provider Name | Benjamin Robert Keyser |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1194141200 PECOS PAC ID: 8628375466 Enrollment ID: I20211118002299 |
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