Individual
MR. ANASTASIOS ATHANASOPOULOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
475 EASTERN AVENUE, LYNN, MA 01902-1633
(781) 598-2232
(781) 598-2264
Mailing address
475 EASTERN AVENUE, LYNN, MA 01902-1633
(781) 598-2232
(781) 598-2264
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18590
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0208981
—
MA
01
—
X12091
BCBS
MA
Enumeration date
07/16/2006
Last updated
07/08/2007
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