| Southeast Pediatric Dentistry And Orthodontics, Pc | |
|
23 Commerce Way Seekonk MA 02771-5816 | |
| (508) 336-4994 | |
| Not Available |
| Full Name | Southeast Pediatric Dentistry And Orthodontics, Pc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 23 Commerce Way, Seekonk, Massachusetts |
| Authorized Official Name and Position | Brian Richard Gaudreault (OWNER) |
| Authorized Official Contact | 5083457075 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Pediatric Dentistry And Orthodontics, Pc 841 Belmont St Brockton MA 02301-5545 Ph: (508) 587-8623 | Southeast Pediatric Dentistry And Orthodontics, Pc 23 Commerce Way Seekonk MA 02771-5816 Ph: (508) 336-4994 |
| NPI Number | 1457772246 |
|---|---|
| Provider Enumeration Date | 12/20/2013 |
| Last Update Date | 12/20/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457772246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 1855240 (Massachusetts) | Secondary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 19702 (Massachusetts) | Primary |
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