Provider Demographics
NPI:1083895924
Name:PETER T MESSIER DDS PC
Entity Type:Organization
Organization Name:PETER T MESSIER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:TAIT
Authorized Official - Last Name:MESSIER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:508-947-7758
Mailing Address - Street 1:259 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346
Mailing Address - Country:US
Mailing Address - Phone:508-947-7758
Mailing Address - Fax:508-947-0029
Practice Address - Street 1:259 CENTER ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346
Practice Address - Country:US
Practice Address - Phone:508-947-7758
Practice Address - Fax:508-947-0029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA114981223G0001X
MA110041223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000217OtherDELTA DENTAL
MAX10770OtherBCBS