Provider Demographics
NPI:1528182284
Name:DAVID C. CORMIER, D.D.S.
Entity Type:Organization
Organization Name:DAVID C. CORMIER, D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:CORMIER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:978-927-0324
Mailing Address - Street 1:495 CABOT ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-2515
Mailing Address - Country:US
Mailing Address - Phone:978-927-0324
Mailing Address - Fax:978-927-9166
Practice Address - Street 1:495 CABOT ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-2515
Practice Address - Country:US
Practice Address - Phone:978-927-0324
Practice Address - Fax:978-927-9166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA166771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty