NPI 1508088857 · live from the CMS NPI Registry
Anthony C Broccoli Jr DMD INC
Dentist, Orthodontics and Dentofacial Orthopedics in Andover, MA. National Provider Identifier 1508088857, active.
NPI record
| NPI | 1508088857 Type 2 · organization |
|---|---|
| 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 3, 2007 |
| Last updated | October 12, 2007 |
| Authorized official | Anthony Broccoli, President |
| Other names | Andover Orthodontics |
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.