Organization
SOUTH SHORE ORAL SURGERY ASSOCIATES CO. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID PAUL LUSTBADER D.M.D. (PRESIDENT)
(617) 773-9500
Entity
Organization
Contact information
Practice address
270 QUINCY AVE, QUINCY, MA 02169-8127
(617) 773-9500
(617) 773-2827
Mailing address
270 QUINCY AVE, QUINCY, MA 02169-8127
(617) 773-9500
(617) 773-2827
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
17663
MA
Other
Enumeration date
01/15/2007
Last updated
06/30/2008
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