Organization
MEDFORD ORAL SURGERY ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE WILLIAM JOYCE DMD (PRESIDENT)
(781) 395-3100
Entity
Organization
Contact information
Practice address
689 FELLSWAY, MEDFORD, MH 02155
(781) 395-3100
(781) 395-3058
Mailing address
689 FELLSWAY, MEDFORD, MA 02155-4931
(781) 395-3100
(781) 395-3058
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
13669
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16170
HARVARD
—
01
—
70434
AETNA US HEALTHCARE
—
Enumeration date
02/22/2006
Last updated
04/07/2009
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