Southeast Orthodontics

NPI #1568800803 in Nantucket, Massachusetts

Provider Information

NPI Number: 1568800803
Entity Type: Organization
Organization Name: Southeast Orthodontics
Primary Specialty: Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date: Jun 10, 2013
Last Updated: Jun 10, 2013

Practice Location

Address: 19 1/2 SURFSIDE ROAD
City: Nantucket
State: Massachusetts
ZIP Code: 02554
Phone: (508) 228-1085

Authorized Official

Name: BRIAN GAUDREAULT
Title: OWNER
Phone: (508) 587-8623

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X	Primary

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