| Richard J Sorbera Dds Shilby D Malouf Dds Inc | |
|
366 Broadway Somerville MA 01245-2812 | |
| (617) 628-8000 | |
| (617) 628-2370 |
| Full Name | Richard J Sorbera Dds Shilby D Malouf Dds Inc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 366 Broadway, Somerville, Massachusetts |
| Authorized Official Name and Position | Shilby D Malouf (VICE PRESIDENT) |
| Authorized Official Contact | 6176288000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard J Sorbera Dds Shilby D Malouf Dds Inc 366 Broadway Somerville MA 01245-2812 Ph: (617) 628-8000 | Richard J Sorbera Dds Shilby D Malouf Dds Inc 366 Broadway Somerville MA 01245-2812 Ph: (617) 628-8000 |
| NPI Number | 1164597217 |
|---|---|
| Provider Enumeration Date | 11/22/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164597217 | NPI | - | NPPES |
| X03044 | Other | MA | RS |
| 0202061 | Medicaid | MA | |
| 0223573 | Medicaid | MA | |
| X03159 | Other | MA | RS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 9637 (Massachusetts) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 9458 (Massachusetts) | Secondary |
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