NPI 1023425808

Commonwealth Periodontics

Organisation Periodontics Worcester, MA

Practice location

Address: 48 Elm St, Worcester, MA 01609-2541
Phone: (150) 875-4122
Fax: (508) 754-9378

Authorised official

Name: Susan Marie Depatie
Title: Director of Operations
Phone: (508) 754-1122

Registered specialties

Periodontics Primary

Dental Providers Taxonomy 1223P0300X Licence 20952 (MA)

Other Dentist providers in Massachusetts →

Registry record

NPI: 1023425808
Entity type: Organization
NPI issued: 14 Jul 2014
Record last updated: 14 Jul 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.