Provider Demographics
NPI:1366863839
Name:HINGHAM DENTAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:HINGHAM DENTAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:PELLEGRINO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-749-1099
Mailing Address - Street 1:20 DOWNER AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-1115
Mailing Address - Country:US
Mailing Address - Phone:781-749-1099
Mailing Address - Fax:
Practice Address - Street 1:20 DOWNER AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-1115
Practice Address - Country:US
Practice Address - Phone:781-749-1099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-30
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN212701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty