Provider Demographics
NPI:1619133360
Name:SANTELLI, JOSEPH (DDSPC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:SANTELLI
Suffix:
Gender:M
Credentials:DDSPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 ENTERPRISE ST
Mailing Address - Street 2:SUITE #9
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-3330
Mailing Address - Country:US
Mailing Address - Phone:781-934-9444
Mailing Address - Fax:781-934-9448
Practice Address - Street 1:33 ENTERPRISE ST
Practice Address - Street 2:SUITE #9
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332
Practice Address - Country:US
Practice Address - Phone:781-934-9444
Practice Address - Fax:781-934-9448
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA121511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice