Individual
DR. NICHOLAS ANDREW VAILLANCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
123 MAIN ST STE 2, GLOUCESTER, MA 01930-5766
(860) 371-6640
(978) 879-4785
Mailing address
123 MAIN ST STE 2, GLOUCESTER, MA 01930-5766
(860) 371-6640
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1857949
MA
Other
Enumeration date
06/11/2018
Last updated
06/22/2022
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