Provider Demographics
NPI:1578644589
Name:RECUPERO, THOMAS A (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:RECUPERO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 PARK STREET
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-0527
Mailing Address - Country:US
Mailing Address - Phone:781-344-5211
Mailing Address - Fax:
Practice Address - Street 1:480 PARK SREET
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-0527
Practice Address - Country:US
Practice Address - Phone:781-344-5211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA97651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice