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Individual

DR. PETER JOSEPH PANTANO

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
955 MAIN ST, SUITE 201, WINCHESTER, MA 01890-1961
(781) 729-5041
Mailing address
955 MAIN ST, SUITE 201, WINCHESTER, MA 01890-4302
(781) 729-5041

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
15556
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
X05442
BLUE CROSS OF MA
MA
Enumeration date
01/23/2006
Last updated
07/08/2007
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