Anthony C Broccoli Jr DMD Inc
Organization Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Andover, MA
NPI 1508088857 · NPPES record last updated Oct 12, 2007
Key facts
- NPI
- 1508088857
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 16891 (MA)
- Legal business name
- ANTHONY C BROCCOLI JR DMD INC
- Practice address
- 15 Central St
Andover, MA 01810 - Phone
- (978) 475-0450
- NPI assigned
- May 3, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Anthony C Broccoli, DMD
- Title
- President
- Phone
- (978) 475-0450
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry |
1223X0400X | 16891 | MA | Yes |
Addresses
Primary practice location
15 Central St
Andover, MA 01810
Mailing address
15 Central St
Andover, MA 01810
Phone (978) 475-0450
Other names
- Andover Orthodontics
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.