NPI 1114149184 · live from the CMS NPI Registry
Anthony C Broccoli, DMD
Dentist, Orthodontics and Dentofacial Orthopedics in Andover, MA. National Provider Identifier 1114149184, active.
NPI record
| NPI | 1114149184 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 15 Central St, Andover, MA 01810 |
| Practice phone | 978-475-0450 |
| Enumerated | May 2, 2007 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | 16891 (MA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.