Provider Demographics
NPI:1154656593
Name:HENRY M. FASSLER, D.M.D., P.C.
Entity Type:Organization
Organization Name:HENRY M. FASSLER, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:MARC
Authorized Official - Last Name:FASSLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-237-0085
Mailing Address - Street 1:422 WORCESTER ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WELLESLEY HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481-5341
Mailing Address - Country:US
Mailing Address - Phone:781-237-0085
Mailing Address - Fax:781-237-7790
Practice Address - Street 1:422 WORCESTER ST
Practice Address - Street 2:SUITE 102
Practice Address - City:WELLESLEY HILLS
Practice Address - State:MA
Practice Address - Zip Code:02481-5341
Practice Address - Country:US
Practice Address - Phone:781-237-0085
Practice Address - Fax:781-237-7790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11139122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty