Individual
VASILIOS VAGENAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5 TORREY STREET, BROCKTON, MA 02301
(508) 586-4276
(508) 513-1403
Mailing address
5 TORREY ST, BROCKTON, MA 02301-4832
(508) 586-4276
(508) 513-1403
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18888
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X11937
BLUE CROSS B SHIELD MA
MA
Enumeration date
02/21/2007
Last updated
03/26/2026
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