| Northern Essex Oral Surgery Assoc Inc | |
|
390 Water Street Haverhill MA 01830 | |
| (978) 374-7451 | |
| (978) 373-8870 |
| Full Name | Northern Essex Oral Surgery Assoc Inc |
|---|---|
| Speciality | Dentist |
| Location | 390 Water Street, Haverhill, Massachusetts |
| Authorized Official Name and Position | Alvin P Yadgood (OWNER PRESIDENT) |
| Authorized Official Contact | 9783747451 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Essex Oral Surgery Assoc Inc 390 Water Street Haverhill MA 01830 Ph: (978) 374-7451 | Northern Essex Oral Surgery Assoc Inc 390 Water Street Haverhill MA 01830 Ph: (978) 374-7451 |
| NPI Number | 1851558274 |
|---|---|
| Provider Enumeration Date | 05/22/2008 |
| Last Update Date | 05/22/2008 |
| Medicare PECOS PAC ID | 2264592203 |
|---|---|
| Medicare Enrollment ID | O20081120000020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851558274 | NPI | - | NPPES |
| M11140 | Other | MA | BLUE CROSS BLUE SHIELD OF MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 16454 (Massachusetts) | Primary |
| Provider Name | Alvin P Yadgood |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1447262084 PECOS PAC ID: 8527128305 Enrollment ID: I20090928000567 |
| Provider Name | Marcin Jarmoc |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1033388228 PECOS PAC ID: 3577865831 Enrollment ID: I20160105000586 |
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