Organization
COASTAL ORTHODONTICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN L OLIVEIRA DMD, MSD (ORTHODONTIST)
(508) 667-2079
Entity
Organization
Contact information
Practice address
1 REBECCA DR, MARION, MA 02738-1296
(508) 667-2079
Mailing address
2421 CRANBERRY HWY, SUITE 316, WAREHAM, MA 02571-5021
(508) 667-2079
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
21731
MA
Other
Enumeration date
08/18/2010
Last updated
08/18/2010
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