Provider Demographics
NPI:1326391715
Name:ONSITE DENTAL CARE
Entity Type:Organization
Organization Name:ONSITE DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REGIONAL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:MAXNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-414-3181
Mailing Address - Street 1:1 CHANDLER DR
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1247
Mailing Address - Country:US
Mailing Address - Phone:508-414-3181
Mailing Address - Fax:
Practice Address - Street 1:1215 MAIN ST
Practice Address - Street 2:UNIT 109
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-4724
Practice Address - Country:US
Practice Address - Phone:508-414-3181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty