Organization
MERRIMACK VALLEY ORAL SURGEONS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATE ACKERMANN (OFFICE MANAGER)
(781) 438-7206
Entity
Organization
Contact information
Practice address
88 MONTVALE AVE, STE 5, STONEHAM, MA 02180-3643
(781) 438-7206
(781) 279-9029
Mailing address
88 MONTVALE AVE, STE 5, STONEHAM, MA 02180-3643
(781) 438-7206
(781) 279-9029
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
702431B
TUFTS
MA
05
—
9774459
—
MA
01
—
X10741
BCBS
MA
Enumeration date
03/28/2007
Last updated
08/22/2020
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