Provider Demographics
NPI:1518928860
Name:NASHOBA FAMILY DENTISTS
Entity Type:Organization
Organization Name:NASHOBA FAMILY DENTISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSIST. MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:GAUGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-534-9216
Mailing Address - Street 1:256 GREAT RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:LITTLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01460-1916
Mailing Address - Country:US
Mailing Address - Phone:978-486-8261
Mailing Address - Fax:978-486-4437
Practice Address - Street 1:256 GREAT RD
Practice Address - Street 2:SUITE 5
Practice Address - City:LITTLETON
Practice Address - State:MA
Practice Address - Zip Code:01460-1916
Practice Address - Country:US
Practice Address - Phone:978-486-8261
Practice Address - Fax:978-486-4437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA156091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA=========OtherTAX ID#