Organization
NANETTE DEMONTEVERDE, DMD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NANETTE CANERO DEMONTEVERDE DMD (PRESIDENT)
(781) 391-2440
Entity
Organization
Contact information
Practice address
30 MAIN ST, MEDFORD, MA 02155-7112
(781) 391-2440
Mailing address
30 MAIN ST, MEDFORD, MA 02155-7112
(781) 391-2440
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16915
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9708791
—
MA
Enumeration date
04/11/2007
Last updated
08/22/2020
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