| Cmoa Pc | |
|
100 Mlk Jr. Boulevard Suite 500 Worcester MA 01608-1209 | |
| (508) 753-2489 | |
| (508) 795-3892 |
| Full Name | Cmoa Pc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 100 Mlk Jr. Boulevard, Worcester, Massachusetts |
| Authorized Official Name and Position | Lisa Marie Giarrusso (PRESIDENT TREASURE CMOA PC ORTHODON) |
| Authorized Official Contact | 5087532489 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cmoa Pc 100 Mlk Jr Blvd Suite 500 Worcester MA 01608-1209 Ph: (508) 753-2489 | Cmoa Pc 100 Mlk Jr. Boulevard Suite 500 Worcester MA 01608-1209 Ph: (508) 753-2489 |
| NPI Number | 1003982786 |
|---|---|
| Provider Enumeration Date | 11/27/2006 |
| Last Update Date | 11/13/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003982786 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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