Southeast Orthodontics, Inc. | |
841 Belmont St Brockton MA 02301-5545 | |
(508) 587-8623 | |
Not Available |
Full Name | Southeast Orthodontics, Inc. |
---|---|
Speciality | Clinic/center - Dental |
Location | 841 Belmont St, Brockton, Massachusetts |
Authorized Official Name and Position | Brian Richard Gaudreault (PRESIDENT) |
Authorized Official Contact | 5085878623 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Southeast Orthodontics, Inc. 841 Belmont Street Brockton MA 02030 Ph: (508) 587-8623 | Southeast Orthodontics, Inc. 841 Belmont St Brockton MA 02301-5545 Ph: (508) 587-8623 |
NPI Number | 1114095361 |
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Provider Enumeration Date | 12/04/2006 |
Last Update Date | 10/03/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114095361 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | 19702 (Massachusetts) | Primary |
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