Full Name | Phoenix Pc |
---|---|
Speciality | Dentist - General Practice |
Location | 165 Westgate Dr, Brockton, Massachusetts |
Authorized Official Name and Position | Peter Mortelliti (OWNER) |
Authorized Official Contact | 3154546000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Phoenix Pc 281 Sanders Creek Pkwy East Syracuse NY 13057-1307 Ph: (315) 454-6000 | Phoenix Pc 165 Westgate Dr Brockton MA 02301-1821 Ph: (781) 335-8355 |
NPI Number | 1275720971 |
---|---|
Provider Enumeration Date | 09/27/2007 |
Last Update Date | 09/27/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275720971 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 13263 (Massachusetts) | Primary |
News Archive
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Jnel Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 715 Crescent St, Brockton, MA 02302 Phone: 508-895-9100 | |
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