Organization
SOUTHEAST ORTHODONTICS
Active
Organization
SOUTHEAST ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN GAUDREAULT (OWNER)
(508) 587-8623
Entity
Organization
Contact information
Practice address
19 1/2 SURFSIDE ROAD, NANTUCKET, MA 02554
(508) 228-1085
Mailing address
841 BELMONT ST, BROCKTON, MA 02301-5545
(508) 587-8623
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
06/10/2013
Last updated
06/10/2013
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