# BAY STATE ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** John M Ristuccia, DDS and Associates, PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821153586
- **Authorized official:** DR. JOHN MICHAEL RISTUCCIA D.D.S. (PRESIDENT)
- **Authorized official phone:** (978) 686-4187

## Contact information

- **Practice address:** 100 AMESBURY ST, SUITE 112, LAWRENCE, MA 01840-1321
- **Practice address phone:** (978) 686-4187
- **Practice address fax:** (978) 686-0941
- **Mailing address:** 100 AMESBURY ST, SUITE 112, LAWRENCE, MA 01840-1321
- **Mailing address phone:** (978) 686-4187
- **Mailing address fax:** (978) 686-0941

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 11590 | MA | Yes |

## Other

- **Enumeration date:** 12/23/2006
- **Last updated:** 08/22/2020