Provider Demographics
NPI:1588842553
Name:PELUSO, CHRISTOPHER WILLIAM
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:WILLIAM
Last Name:PELUSO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 2ND ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-2125
Mailing Address - Country:US
Mailing Address - Phone:508-222-9932
Mailing Address - Fax:508-222-9644
Practice Address - Street 1:2 2ND ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2125
Practice Address - Country:US
Practice Address - Phone:508-222-9932
Practice Address - Fax:508-222-9644
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213221223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics