Provider Demographics
NPI:1164589867
Name:STUART CUSHNER, D.M.D.,P.C.
Entity Type:Organization
Organization Name:STUART CUSHNER, D.M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:CUSHNER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD PC
Authorized Official - Phone:508-824-8030
Mailing Address - Street 1:2 KNOTTY WALK
Mailing Address - Street 2:PO BOX 2791
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-3249
Mailing Address - Country:US
Mailing Address - Phone:508-824-8030
Mailing Address - Fax:
Practice Address - Street 1:2 KNOTTY WALK
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3249
Practice Address - Country:US
Practice Address - Phone:508-824-8030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA153141223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty