NPI 1316915788 · live from the CMS NPI Registry
David M. Petrarca, DDS & Sungyon Bang, DMD, P.C.
Dentist, Pediatric Dentistry in Medford, MA. National Provider Identifier 1316915788, active.
NPI record
| NPI | 1316915788 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Pediatric Dentistry 1223P0221X |
| Practice location | 80 High St, Medford, MA 02155 |
| Practice phone | 781-391-8300 |
| Enumerated | March 10, 2006 |
| Last updated | January 16, 2020 |
| Authorized official | David Petrarca, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics | 1223X0400X | — (MA) |
| Dentist, Pediatric Dentistry primary | 1223P0221X | — (MA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.