Provider Demographics
NPI:1437205192
Name:STEPHEN J. NOXON, DMD, MSD, PC
Entity Type:Organization
Organization Name:STEPHEN J. NOXON, DMD, MSD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:NOXON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD MSD
Authorized Official - Phone:781-235-7181
Mailing Address - Street 1:486 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-5971
Mailing Address - Country:US
Mailing Address - Phone:781-235-7181
Mailing Address - Fax:781-235-7539
Practice Address - Street 1:486 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-5971
Practice Address - Country:US
Practice Address - Phone:781-235-7181
Practice Address - Fax:781-235-7539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA205251223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty