Provider Demographics
NPI:1346474327
Name:NORWELL PEDIATRIC DENTISTRY, LLC
Entity Type:Organization
Organization Name:NORWELL PEDIATRIC DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHREIER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:781-659-7442
Mailing Address - Street 1:317 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1701
Mailing Address - Country:US
Mailing Address - Phone:781-659-7442
Mailing Address - Fax:781-659-4850
Practice Address - Street 1:317 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1701
Practice Address - Country:US
Practice Address - Phone:781-659-7442
Practice Address - Fax:781-659-4850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA117411223P0221X
MA207791223P0221X
MA212751223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty