| Southeast Orthodontics | |
|
100 Copeland Dr Ste 9 Mansfield MA 02048-1245 | |
| (508) 339-5500 | |
| Not Available |
| Full Name | Southeast Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 100 Copeland Dr Ste 9, Mansfield, Massachusetts |
| Authorized Official Name and Position | Brian R Gaudreault (OWNER/PRESIDENT) |
| Authorized Official Contact | 5088805891 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Orthodontics 302 Broadway Unit 6 Raynham MA 02767-1439 Ph: (508) 880-5891 | Southeast Orthodontics 100 Copeland Dr Ste 9 Mansfield MA 02048-1245 Ph: (508) 339-5500 |
| NPI Number | 1487183265 |
|---|---|
| Provider Enumeration Date | 06/06/2017 |
| Last Update Date | 06/06/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487183265 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 19702 (Marshall Islands) | Primary |
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