Organization
LAURIE MANTHOS, D.M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURIE MANTHOS D.M.D. (OWNER)
(508) 752-2100
Entity
Organization
Contact information
Practice address
200 LINCOLN ST, SUITE 1, WORCESTER, MA 01605-2528
(508) 752-2100
Mailing address
200 LINCOLN ST, SUITE 1, WORCESTER, MA 01605-2528
(508) 752-2100
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
16823
MA
Other
Enumeration date
03/21/2007
Last updated
01/11/2008
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