Provider Demographics
NPI:1093036691
Name:NORTH SHORE SMILES
Entity Type:Organization
Organization Name:NORTH SHORE SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-592-9779
Mailing Address - Street 1:1 POST OFFICE SQUARE
Mailing Address - Street 2:LYNNFIELD MEDICAL
Mailing Address - City:LYNNFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01940
Mailing Address - Country:US
Mailing Address - Phone:781-592-9779
Mailing Address - Fax:781-592-5780
Practice Address - Street 1:1 POST OFFICE SQUARE
Practice Address - Street 2:LYNNFIELD MEDICAL
Practice Address - City:LYNNFIELD
Practice Address - State:MA
Practice Address - Zip Code:01940
Practice Address - Country:US
Practice Address - Phone:781-592-9779
Practice Address - Fax:781-592-5780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty