Individual
DR. PAUL ANTHONY FUGAZZOTTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
25 HIGH ST, SUITE 103, MILTON, MA 02186-3426
(671) 696-7257
(617) 696-6635
Mailing address
25 HIGH ST, SUITE 103, MILTON, MA 02186-3426
(671) 696-7257
(617) 696-6635
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
14401
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X10364
BLUE CROSS & BLUE SHIELD
MA
01
—
X31025
HARVARD PILGRIM HEALTH CA
MA
Enumeration date
03/21/2007
Last updated
07/08/2007
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