Organization
BRAVMAN LANGSTON AND ASSOCIATES ORAL & MAXILLOFACIAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN R. LANGSTON DDS, MS (OWNER)
(508) 759-4495
Entity
Organization
Contact information
Practice address
114 WATERHOUSE RD, BOURNE, MA 02532-8340
(508) 759-4495
(508) 759-0840
Mailing address
114 WATERHOUSE RD, BOURNE, MA 02532-8340
(508) 759-4495
(508) 759-0840
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DX9762
MEDICARE PTAN
MA
01
—
M20758
MEDICARE GRP
MA
01
—
X11223
BCBS
MA
Enumeration date
04/04/2008
Last updated
12/27/2017
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