Organization
TIMOTHS S GULDEMOND DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY SCOTT GULDEMOND DDS (OWNER/DENTIST)
(978) 462-5410
Entity
Organization
Contact information
Practice address
143 STATE ST, UNIT 1, NEWBURYPORT, MA 01950-6621
(978) 462-5410
(978) 465-7822
Mailing address
143 STATE ST, UNIT 1, NEWBURYPORT, MA 01950-6621
(978) 462-5410
(978) 465-7822
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
16820
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X06145GU
BCBS
MA
Enumeration date
11/01/2005
Last updated
08/22/2020
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