Provider Demographics
NPI:1528200508
Name:ANDOVER ENDODONTICS, INC
Entity Type:Organization
Organization Name:ANDOVER ENDODONTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAVIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-686-3500
Mailing Address - Street 1:140 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-5918
Mailing Address - Country:US
Mailing Address - Phone:978-686-3500
Mailing Address - Fax:978-686-3514
Practice Address - Street 1:140 WILLOW ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5918
Practice Address - Country:US
Practice Address - Phone:978-686-3500
Practice Address - Fax:978-686-3514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA219961223E0200X
MA183651223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty