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Organization

COPPE PEDIATRIC DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CAROLYN COPPE (ACCOUNT MANAGER)
(781) 861-6120
Entity
Organization

Contact information

Practice address
19 MUZZEY ST, SUITE 6, LEXINGTON, MA 02421-5256
(781) 861-6120
Mailing address
19 MUZZEY STREET, SUITE 6, LEXINGTON, MA 02421
(781) 861-6120

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
11347
MA
261QM1300X
Multi-Specialty Clinic/Center
11347
MA

Other

Enumeration date
10/10/2013
Last updated
01/14/2016
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