Organization
BAGNALL FAMILY DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW LEE BAGNALL DMD (OWNER)
(978) 475-3997
Entity
Organization
Contact information
Practice address
16 HAVERHILL ST, ANDOVER, MA 01810-3002
(978) 475-3997
(978) 409-6065
Mailing address
16 HAVERHILL ST, ANDOVER, MA 01810-3002
(978) 475-3997
(978) 409-6065
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1856571
MA
Other
Enumeration date
02/26/2018
Last updated
02/26/2018
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