Provider Demographics
NPI:1467602698
Name:ARMOND ENOS JR
Entity Type:Organization
Organization Name:ARMOND ENOS JR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMOND
Authorized Official - Middle Name:H
Authorized Official - Last Name:ENOS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:508-881-4550
Mailing Address - Street 1:300 ELIOT STREET
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721
Mailing Address - Country:US
Mailing Address - Phone:508-881-4550
Mailing Address - Fax:508-881-2520
Practice Address - Street 1:300 ELIOT STREET
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:MA
Practice Address - Zip Code:01721
Practice Address - Country:US
Practice Address - Phone:508-881-4550
Practice Address - Fax:508-881-2520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA148871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0265357Medicaid
MA314887OtherDELTA
MAV02771OtherBC/BS