Provider Demographics
NPI:1225769177
Name:STELIOS TSARTSIDIS DMD PC
Entity Type:Organization
Organization Name:STELIOS TSARTSIDIS DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STELIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:TSARTSIDIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-963-6077
Mailing Address - Street 1:10 POSSUM RUN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-3609
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1395 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-1768
Practice Address - Country:US
Practice Address - Phone:781-963-6077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty