Organization
FITCHBURGH DENTISTRY AND BRACES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNE TAVANO (CHIEF OPERATING OFFICER)
(978) 580-1524
Entity
Organization
Contact information
Practice address
505 JOHN FITCH HWY, FITCHBURG, MA 01420-8403
(508) 460-0632
Mailing address
5 MOUNT ROYAL AVE, SUITE 300, MARLBOROUGH, MA 01752-1981
(508) 460-0632
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
10/21/2016
Last updated
10/21/2016
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