Organization
ENDODONTIC SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUDOLPH L LANTELME D.D.S. (ENDODONTIST)
(978) 687-3131
Entity
Organization
Contact information
Practice address
13 BRANCH ST, METHUEN, MA 01844-1975
(978) 687-3131
(978) 687-7009
Mailing address
13 BRANCH ST, METHUEN, MA 01844-1975
(978) 687-3131
(978) 687-7009
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X11812
BLUE CROSS BLUE SHIELD
MA
Enumeration date
11/02/2006
Last updated
08/22/2020
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