| Matthew R. Fantasia, D.m.d., P.c. | |
|
372 Washington St Wellesley MA 02481-6202 | |
| (781) 235-1146 | |
| (781) 235-9195 |
| Full Name | Matthew R. Fantasia, D.m.d., P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 372 Washington St, Wellesley, Massachusetts |
| Authorized Official Name and Position | Matthew R. Fantasia (PRESIDENT) |
| Authorized Official Contact | 7812351146 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew R. Fantasia, D.m.d., P.c. 372 Washington St Wellesley MA 02481-6202 Ph: (781) 235-1146 | Matthew R. Fantasia, D.m.d., P.c. 372 Washington St Wellesley MA 02481-6202 Ph: (781) 235-1146 |
| NPI Number | 1386995397 |
|---|---|
| Provider Enumeration Date | 10/01/2012 |
| Last Update Date | 10/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386995397 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN 20441 (Massachusetts) | Primary |
| 1223P0700X | Dentist - Prosthodontics | DN 14506 (Massachusetts) | Secondary |
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