Provider Demographics
NPI:1295848984
Name:DENTISTRY BY DESIGN, P.C.
Entity Type:Organization
Organization Name:DENTISTRY BY DESIGN, P.C.
Other - Org Name:ANDOVER FAMILY DENTISTRY, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:THEODORE
Authorized Official - Last Name:PAPAPETROS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-475-5333
Mailing Address - Street 1:19 BARNARD ST
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-3601
Mailing Address - Country:US
Mailing Address - Phone:978-475-5333
Mailing Address - Fax:978-470-0287
Practice Address - Street 1:19 BARNARD ST
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3601
Practice Address - Country:US
Practice Address - Phone:978-475-5333
Practice Address - Fax:978-470-0287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA180931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty