Provider Demographics
NPI:1306207766
Name:MILFORD BRACES PC
Entity Type:Organization
Organization Name:MILFORD BRACES PC
Other - Org Name:SIMPLY ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:AIGUIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-308-5361
Mailing Address - Street 1:77 W MAIN ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-1684
Mailing Address - Country:US
Mailing Address - Phone:617-308-5361
Mailing Address - Fax:
Practice Address - Street 1:77 W MAIN ST
Practice Address - Street 2:SUITE 209
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748-1684
Practice Address - Country:US
Practice Address - Phone:617-308-5361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty