Organization
PAUL E TESONE DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL E TESONE DDS (OWNER)
(617) 389-4950
Entity
Organization
Contact information
Practice address
563 BROADWAY, SUITE 4, EVERETT, MA 02149
(617) 389-4950
(617) 389-8604
Mailing address
563 BROADWAY S, SUITE 4, EVERETT, MA 02149
(617) 389-4950
(617) 389-8604
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
11620
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0230111
—
MA
01
—
X03773
BCBS
MA
01
—
X11108
BCBS
MA
Enumeration date
06/14/2007
Last updated
08/22/2020
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