Provider Demographics
NPI:1437510815
Name:WESCOTT, ANA TEREZA T
Entity Type:Individual
Prefix:
First Name:ANA TEREZA
Middle Name:T
Last Name:WESCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANA TEREZA
Other - Middle Name:M
Other - Last Name:TONET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27 CONGRESS ST STE 513
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-5523
Mailing Address - Country:US
Mailing Address - Phone:978-744-8388
Mailing Address - Fax:978-744-0079
Practice Address - Street 1:89 FOSTER STREET
Practice Address - Street 2:PEABODY FAMILY HEALTH CENTER
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960
Practice Address - Country:US
Practice Address - Phone:978-532-4903
Practice Address - Fax:978-532-4995
Is Sole Proprietor?:No
Enumeration Date:2016-03-14
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL13892122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist