Organization
PERICO, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER J WISE D.D.S. (PRESIDENT)
(781) 596-2220
Entity
Organization
Contact information
Practice address
90 HUMPHREY ST, SWAMPSCOTT, MA 01907-2542
(781) 596-2220
(781) 598-8050
Mailing address
90 HUMPHREY ST, SWAMPSCOTT, MA 01907-2542
(781) 596-2220
(781) 598-8050
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
11662
MA
Other
Enumeration date
04/24/2009
Last updated
04/24/2009
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