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Organization
SOUTHEASTERN ORAL & MAXILLOFACIAL SURGEONS PC
Active
Organization
SOUTHEASTERN ORAL & MAXILLOFACIAL SURGEONS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN F COYNE DMD (PRESIDENT)
(508) 588-0200
Entity
Organization
Contact information
Practice address
951 NORTH MAIN STREET, BROCKTON, MA 02301
(508) 588-0200
(508) 583-6156
Mailing address
951 NORTH MAIN STREET, BROCKTON, MA 02301
(508) 588-0200
(508) 583-6156
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
18127
MA
Other
Enumeration date
11/01/2006
Last updated
08/22/2020
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