Provider Demographics
NPI:1093905036
Name:PATRICK ASSIOUN DMD PC
Entity Type:Organization
Organization Name:PATRICK ASSIOUN DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ASSIOUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-485-2001
Mailing Address - Street 1:116 MAIN STREET
Mailing Address - Street 2:PATRICK ASSIOUN DMD PC
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752
Mailing Address - Country:US
Mailing Address - Phone:508-485-2001
Mailing Address - Fax:
Practice Address - Street 1:116 MAIN STREET
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752
Practice Address - Country:US
Practice Address - Phone:508-485-2001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty