Atlantic Coast Oral Maxillofacial Surgery, PC
Organization Active NPI Oral & Maxillofacial Surgery (D.M.D.) · Swansea, MA
NPI 1366732141 · NPPES record last updated Apr 13, 2011
Key facts
- NPI
- 1366732141
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.) 204E00000X
- License
- MD 00035886 (WA)
- Legal business name
- ATLANTIC COAST ORAL MAXILLOFACIAL SURGERY, PC
- Practice address
- 1010 Gar Hwy
Suite #6
Swansea, MA 02777-4566 - Phone
- (508) 676-3041
- Fax
- (508) 678-0222
- NPI assigned
- Apr 13, 2011
- Organization subpart
- No
Authorized official
- Name
- Dr. Peter H Hertz, DDS, MD
- Title
- Owner
- Phone
- (360) 830-6637
Practitioners 1
-
Peter H. Hertz, MD, DDS
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110613000226 | MA | Part B Supplier - Clinic/Group Practice | 7416134887 |
Receives reassigned benefits from 1 practitioner Practice locations: Swansea, MA |
National Provider Directory
Locations
1010 Gar Hwy
Ste 6
Swansea, MA 02777
Phone (508) 676-3041
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral & Maxillofacial Surgery (D.M.D.) |
204E00000X | MD 00035886 | WA | Yes |
Addresses
Primary practice location
1010 Gar Hwy
Suite #6
Swansea, MA 02777-4566
Mailing address
1010 Gar Hwy
Suite #6
Swansea, MA 02777-4566
Phone (508) 676-3041
Other providers in Swansea, MA
- Arc Hael, Inc.
- Armour Healthcare LLC
- Edwin Thomas Arnold Jr.
- Ashley Gomes-Moore, DMD PLLC
- Athelas Counseling and Consulting, PLLC
- Alyssa Barbara Aubut
- Back Into Balance, Inc
- Amy Lynn Bailey
- Gloria L Bajor
- Jahvani Baker
All providers in Swansea, MA · Oral & Maxillofacial Surgery (D.M.D.) in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.