Organization
MARIA L SEGURA DMD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN M ANTONELLI (OFFICE MANAGER)
(508) 588-0094
Entity
Organization
Contact information
Practice address
304 PLEASANT ST, BROCKTON, MA 02301-3234
(508) 588-0094
Mailing address
304 PLEASANT ST, BROCKTON, MA 02301-3234
(508) 588-0094
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568536811
DMD
MA
01
—
1861575268
DDS
MA
01
—
1891845525
DMD
MA
01
—
1912106303
DDS
MA
Enumeration date
01/06/2023
Last updated
01/06/2023
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