Organization
DR. ROLAND G. NENTWICH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROLAND GERALD NENTWICH D.D.S. (ORTHODONTIST)
(508) 845-6711
Entity
Organization
Contact information
Practice address
506 MAIN STREET, SHREWSBURY, MA 01545
(508) 845-6711
(508) 842-0648
Mailing address
506 MAIN STREET, SHREWSBURY, MA 01545
(508) 845-6711
(508) 842-0648
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12628
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366469355
PERSONAL IDENTIFITICATION NUMBER
MA
Enumeration date
01/20/2009
Last updated
01/20/2009
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