Organization
JOHN L. BENECCHI, DMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN L BENECCHI DMD (OWNER)
(781) 289-0839
Entity
Organization
Contact information
Practice address
140 SCHOOL ST, REVERE, MA 02151-3013
(781) 289-0839
(781) 286-1949
Mailing address
140 SCHOOL ST, REVERE, MA 02151-3013
(781) 289-0839
(781) 286-1949
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13275
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0250023
—
MA
Enumeration date
12/04/2008
Last updated
12/04/2008
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