Periodontology Assoc | |
290 Baker Ave S103 Concord MA 01742 | |
(978) 369-5521 | |
(978) 369-5591 |
Full Name | Periodontology Assoc |
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Speciality | Dentist - Periodontics |
Location | 290 Baker Ave, Concord, Massachusetts |
Authorized Official Name and Position | Jeffrey B Freedman (OWNER) |
Authorized Official Contact | 9783695521 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Periodontology Assoc 290 Baker Ave S103 Concord MA 01742 Ph: (978) 369-5521 | Periodontology Assoc 290 Baker Ave S103 Concord MA 01742 Ph: (978) 369-5521 |
NPI Number | 1407964901 |
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Provider Enumeration Date | 08/26/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407964901 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0300X | Dentist - Periodontics | 13998 (Massachusetts) | Primary |
1223P0300X | Dentist - Periodontics | 19000 (Massachusetts) | Secondary |
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