Commonwealth Periodontics
NPI #1023425808 in Worcester, Massachusetts
Provider Information
- NPI Number
- 1023425808
- Entity Type
- Organization
- Organization Name
- Commonwealth Periodontics
- Primary Specialty
- Dentist - Periodontics
- Enumeration Date
- Jul 14, 2014
- Last Updated
- Jul 14, 2014
Practice Location
- Address
- 48 ELM ST
- City
- Worcester
- State
- Massachusetts
- ZIP Code
- 01609-2541
- Phone
- (150) 875-4122
Authorized Official
- Name
- SUSAN MARIE DEPATIE
- Title
- DIRECTOR OF OPERATIONS
- Phone
- (508) 754-1122
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Periodontics — Periodontics |
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