Organization
DR. DENTAL OF METHUEN, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS INCOLLINGO (MANAGER)
(617) 887-2100
Entity
Organization
Contact information
Practice address
162 HAVERHILL ST, METHUEN, MA 01844-3462
(617) 887-2100
(617) 887-2102
Mailing address
162 HAVERHILL ST, METHUEN, MA 01844-3462
(617) 887-2100
(617) 887-2102
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
20485
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9794395
—
MA
Enumeration date
05/18/2011
Last updated
05/18/2011
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