Organization
NORTH SHORE ADVANCED COSMETIC & FAMILY DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD LAFAUCI DMD (OWNER)
(978) 536-0212
Entity
Organization
Contact information
Practice address
ONE ROOSEVELT AVE, SUITE 203, PEABODY, MA 01960
(978) 536-0212
Mailing address
ONE ROOSEVELT AVE, SUITE 203, PEABODY, MA 01960
(978) 536-0212
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X11801
BCBS
—
Enumeration date
04/27/2007
Last updated
08/22/2020
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