Organization
TRUSTEES OF TUFTS UNIVERSITY
Active
Other names
Tufts Dental Facilty Hogan
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN PATRICK MORGAN JR. (ADMINISTRATIVE DIRECTOR)
(781) 899-6020
Entity
Organization
Contact information
Practice address
450 MAPLE ST, HATHORNE, MA 01937
(978) 774-5000
(978) 774-5000
Mailing address
450 MAPLE ST, HATHORNE, MA 01937
(978) 774-5000
(978) 774-5000
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
20040
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0272248
MASSHEALTH PROVIDER NUMBE
MA
Enumeration date
04/17/2007
Last updated
08/22/2020
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