Provider Demographics
NPI:1568615557
Name:BRANDON L. CAIRO, DMD, PC
Entity Type:Organization
Organization Name:BRANDON L. CAIRO, DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:L
Authorized Official - Last Name:CAIRO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-852-5200
Mailing Address - Street 1:102 SHORE DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-3154
Mailing Address - Country:US
Mailing Address - Phone:508-852-5200
Mailing Address - Fax:520-842-5200
Practice Address - Street 1:102 SHORE DR
Practice Address - Street 2:SUITE 204
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-3154
Practice Address - Country:US
Practice Address - Phone:508-852-5200
Practice Address - Fax:520-842-5200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19273122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty