Organization
DR. MICKEY'S ORTHODONTICS, L.L.C.
Active
Parent organization
EUGENE A MICKEY, DMD, MPH, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
EUGENE A MICKEY, DMD, MPH, PC
Authorized official
DR. EUGENE A MICKEY DMD (PRESIDENT/OWNER)
(781) 279-2400
Entity
Organization
Contact information
Practice address
92 MONTVALE AVE, SUITE 4300, STONEHAM, MA 02180-3647
(781) 279-2400
Mailing address
92 MONTVALE AVE, SUITE 4300, STONEHAM, MA 02180-3647
(781) 279-2400
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN20656
MA
Other
Enumeration date
03/21/2013
Last updated
03/21/2013
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