Organization
ACCESSIBLE DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MARK MINER (OWNER)
(508) 325-0583
Entity
Organization
Contact information
Practice address
15 AMELIA DR, NANTUCKET, MA 02554-6063
(508) 325-0583
Mailing address
15 AMELIA DR, NANTUCKET, MA 02554-6063
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9794883
—
MA
Enumeration date
07/11/2008
Last updated
07/11/2008
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