| Beverly Dentistry and Braces PC | |
|
55 Dodge St Ste A-190 Beverly MA 01915-1705 | |
| (508) 872-3072 | |
| (508) 872-0781 |
| Full Name | Beverly Dentistry and Braces PC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 55 Dodge St Ste A-190, Beverly, Massachusetts |
| Authorized Official Name and Position | Joanne Tavano (CFO) |
| Authorized Official Contact | 9785801524 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beverly Dentistry and Braces PC 5 Mount Royal Ave Ste 300 Marlborough MA 01752-1900 Ph: (508) 872-3072 | Beverly Dentistry and Braces PC 55 Dodge St Ste A-190 Beverly MA 01915-1705 Ph: (508) 872-3072 |
| NPI Number | 1407446941 |
|---|---|
| Provider Enumeration Date | 01/19/2021 |
| Last Update Date | 01/19/2021 |
| Certification Date | 01/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407446941 | NPI | - | NPPES |
| 110078301A | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (NU) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (NU) | Secondary |
Beverly Dental Care PC Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 109 Dodge St, Beverly, MA 01915 Phone: 978-927-3966 |
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