Provider Demographics
NPI:1003584335
Name:CONTEMPORARY PROSTHODONTICS P.C.
Entity Type:Organization
Organization Name:CONTEMPORARY PROSTHODONTICS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:S
Authorized Official - Last Name:WIEMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-934-2300
Mailing Address - Street 1:104 TREMONT ST STE 2
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-4750
Mailing Address - Country:US
Mailing Address - Phone:781-934-2300
Mailing Address - Fax:781-934-0247
Practice Address - Street 1:104 TREMONT ST STE 2
Practice Address - Street 2:
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-4750
Practice Address - Country:US
Practice Address - Phone:781-934-2300
Practice Address - Fax:781-934-0247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-01
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty