Provider Demographics
NPI:1073771978
Name:DUANE F. CARBONE, D.M.D. & RICHARD J. GILBRIDE, D.M.D., INC.
Entity Type:Organization
Organization Name:DUANE F. CARBONE, D.M.D. & RICHARD J. GILBRIDE, D.M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:GILBRIDE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-933-0350
Mailing Address - Street 1:550 CABOT ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-2511
Mailing Address - Country:US
Mailing Address - Phone:978-922-4093
Mailing Address - Fax:978-922-1156
Practice Address - Street 1:550 CABOT ST
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-2511
Practice Address - Country:US
Practice Address - Phone:978-922-4093
Practice Address - Fax:978-922-1156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA173921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty