NPI 1134601669

Derrick Glen Tengco, DMD

Practitioner Dentist Lawrence, MA

Practice location

Address: 314 Essex St, Lawrence, MA 01840-1411
Phone: (605) 714-5114
Mailing address: 1 Nassau St APT 909, Boston, MA 02111-1554

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence DN1858105 (MA)

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Registry record

NPI: 1134601669
Entity type: Individual
Sex (as registered): Male
NPI issued: 31 Aug 2018
Record last updated: 31 Aug 2018

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.