| Northeast Oral Surgery & Dental Implant Center | |
|
203 Turnpike St Ste G-2 North Andovor MA 01845 | |
| (978) 682-5255 | |
| (978) 682-0656 |
| Full Name | Northeast Oral Surgery & Dental Implant Center |
|---|---|
| Speciality | Dentist |
| Location | 203 Turnpike St, North Andovor, Massachusetts |
| Authorized Official Name and Position | Michael Timothy Shannon (ORAL & MAXILLOFACIAL SURGEON PRESID) |
| Authorized Official Contact | 9786825255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Oral Surgery & Dental Implant Center 203 Turnpike Street Suite G-2 North Andovor MA 01845 Ph: (978) 682-5255 | Northeast Oral Surgery & Dental Implant Center 203 Turnpike St Ste G-2 North Andovor MA 01845 Ph: (978) 682-5255 |
| NPI Number | 1295841757 |
|---|---|
| Provider Enumeration Date | 08/21/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8729164330 |
|---|---|
| Medicare Enrollment ID | O20080324000461 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295841757 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Michael T Shannon |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1649378449 PECOS PAC ID: 1850482050 Enrollment ID: I20070802000051 |
| Provider Name | Michael J Hunter |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1376641175 PECOS PAC ID: 6204911605 Enrollment ID: I20080310000402 |