Provider Demographics
NPI:1326552514
Name:MIDDLETON SMILES
Entity Type:Organization
Organization Name:MIDDLETON SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:COGNATA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-237-5800
Mailing Address - Street 1:2 CENTRAL ST STE 202
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01949-1736
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 CENTRAL ST STE 202
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:MA
Practice Address - Zip Code:01949-1736
Practice Address - Country:US
Practice Address - Phone:978-237-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA13926OtherBOARD OF REGISTRATION DENTISTRY