| Bay State Oral & Maxillofacial Surgery Associates, P.c. | |
|
100 Amesbury St Suite 112 Lawrence MA 01840-1321 | |
| (978) 686-4187 | |
| (978) 686-0941 |
| Full Name | Bay State Oral & Maxillofacial Surgery Associates, P.c. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 100 Amesbury St, Lawrence, Massachusetts |
| Authorized Official Name and Position | John Michael Ristuccia (PRESIDENT) |
| Authorized Official Contact | 9786864187 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bay State Oral & Maxillofacial Surgery Associates, P.c. 100 Amesbury St Suite 112 Lawrence MA 01840-1321 Ph: (978) 686-4187 | Bay State Oral & Maxillofacial Surgery Associates, P.c. 100 Amesbury St Suite 112 Lawrence MA 01840-1321 Ph: (978) 686-4187 |
| NPI Number | 1821153586 |
|---|---|
| Provider Enumeration Date | 12/23/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821153586 | NPI | - | NPPES |
| 0024745 | Other | MA | CIGNA HEALTHCARE |
| 585304 | Other | MA | UNITED CONCORDIA |
| M11729 | Other | MA | BLUE CROSS BLUE SHIELD |
| 600593 | Other | MA | TUFTS HEALTH PLAN |
| 689643 | Other | MA | TUFTS HEALTH PLAN |
| X10821 | Other | MA | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 11590 (Massachusetts) | Primary |
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