Individual
DR. MATTHEW LEE BAGNALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
16 HAVERHILL ST, ANDOVER, MA 01810-3002
(978) 475-3997
Mailing address
16 HAVERHILL ST, ANDOVER, MA 01810-3002
(978) 475-3997
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1856571
MA
Other
Enumeration date
02/19/2012
Last updated
06/25/2014
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