Organization
PREMIER ORAL SURGERY AND IMPLANTOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD PACHELLO (PRESIDENT CHIEF REVENUE OFFICER)
(720) 475-6482
Entity
Organization
Contact information
Practice address
209 HARVARD ST STE 307, BROOKLINE, MA 02446-5005
(617) 468-5110
(617) 468-5111
Mailing address
209 HARVARD ST STE 307, BROOKLINE, MA 02446-5005
(617) 468-5110
(617) 468-5111
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
11/09/2021
Last updated
01/28/2026
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