| Phoenix Pc | |
|
165 Westgate Dr Brockton MA 02301-1821 | |
| (781) 335-8355 | |
| Not Available |
| Full Name | Phoenix Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 165 Westgate Dr, Brockton, Massachusetts |
| Authorized Official Name and Position | Peter Mortelliti (OWNER) |
| Authorized Official Contact | 3154546000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Pc 281 Sanders Creek Pkwy East Syracuse NY 13057-1307 Ph: (315) 454-6000 | Phoenix Pc 165 Westgate Dr Brockton MA 02301-1821 Ph: (781) 335-8355 |
| NPI Number | 1275720971 |
|---|---|
| Provider Enumeration Date | 09/27/2007 |
| Last Update Date | 09/27/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275720971 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 13263 (Massachusetts) | Primary |
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