Organization
SOUTHEAST PEDIATRIC DENTISTRY AND ORTHODONTICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN RICHARD GAUDREAULT DMD (OWNER)
(508) 345-7075
Entity
Organization
Contact information
Practice address
23 COMMERCE WAY, SEEKONK, MA 02771-5816
(508) 336-4994
Mailing address
841 BELMONT ST, BROCKTON, MA 02301-5545
(508) 587-8623
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
1855240
MA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
19702
MA
Other
Enumeration date
12/20/2013
Last updated
12/20/2013
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up