Organization
RICHARD H BUSH DDS W WESLEY REED DMD STEVEN FORGIONE DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY R GRESLA DDS (ENDODONTIST)
(781) 729-6622
Entity
Organization
Contact information
Practice address
47 SHORE ROAD, WINCHESTER, MA 01890
(781) 729-6622
(781) 729-0183
Mailing address
47 SHORE ROAD, WINCHESTER, MA 01890
(781) 729-6622
(781) 729-0183
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
12252
MA
1223E0200X
Endodontics
15909
MA
1223E0200X
Endodontics
Primary
19631
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X10426DR
BCBS OFFICE NUMBER TWO
MA
01
—
X10427DR
BCBS OFFICE NUMBER ONE
MA
Enumeration date
10/04/2006
Last updated
08/22/2020
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