Organization
GREGORY T BODRIE OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY TAYLOR BODRIE OD (OWNER)
(508) 888-2020
Entity
Organization
Contact information
Practice address
66 PLEASANT ST., SAGAMORE, MA 02561-0532
(508) 888-2020
(508) 888-4423
Mailing address
PO BOX 532, 66 PLEASANT STREET, SAGAMORE, MA 02561-0532
(508) 888-2020
(508) 888-4423
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2646
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0332003
—
MA
01
—
W15268
BLUE CROSS / BLUE SHIELD
MA
Enumeration date
02/13/2008
Last updated
06/26/2009
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