Organization
DENTAL SURGEONS OF FALL RIVER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN A MARSHALL D.M.D. (OWNER)
(508) 672-1069
Entity
Organization
Contact information
Practice address
180 ELSBREE ST, FALL RIVER, MA 02720-7212
(508) 672-1069
(508) 672-3848
Mailing address
180 ELSBREE ST, FALL RIVER, MA 02720-7212
(508) 672-1069
(508) 672-3848
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
18730
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X11833
BCBS MA
MA
01
—
X12118
BCBS MA
MA
Enumeration date
08/09/2006
Last updated
01/26/2015
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