| Commonwealth Periodontics | |
|
48 Elm St Worcester MA 01609-2541 | |
| (150) 875-4122 | |
| (508) 754-9378 |
| Full Name | Commonwealth Periodontics |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 48 Elm St, Worcester, Massachusetts |
| Authorized Official Name and Position | Susan Marie Depatie (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 5087541122 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Commonwealth Periodontics 48 Elm St Worcester MA 01609-2541 Ph: (150) 875-4122 | Commonwealth Periodontics 48 Elm St Worcester MA 01609-2541 Ph: (150) 875-4122 |
| NPI Number | 1023425808 |
|---|---|
| Provider Enumeration Date | 07/14/2014 |
| Last Update Date | 07/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023425808 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 20952 (Massachusetts) | Primary |
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