Individual
BRAD A BEAUDOIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
04023
NH
122300000X
Dentist
DEN4193
ME
122300000X
Dentist
DN1856415
MA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN1856415
MA
Other
Enumeration date
07/06/2011
Last updated
10/12/2018
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