Organization
COMMONWEALTH OF MASSACHUSETTS
Active
Parent organization
COMMONWEALTH OF MASSACHUSETTS
Other names
Plymouth Area Office, DDS PLYMOUTH AREA OFFICE
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMONWEALTH OF MASSACHUSETTS
Authorized official
DYLAN LATTIMORE (DEPUTY COMMISSIONER FOR ADMINISTRAT)
(857) 408-0675
Entity
Organization
Contact information
Practice address
38 INDUSTRIAL PARK ROAD, SUITE 1, PLYMOUTH, MA 02360
(508) 732-5700
(508) 747-3616
Mailing address
40 BROAD STREET, 4TH FLOOR, BOSTON, MA 02109
(617) 727-5608
(617) 624-7577
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
EXEMPT
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110000087L
—
MA
05
—
1813072
—
MA
Enumeration date
03/12/2007
Last updated
03/19/2026
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