Provider Demographics
NPI:1689448656
Name:ORAL SURGERY SOUTH-QUALITAS, PC
Entity Type:Organization
Organization Name:ORAL SURGERY SOUTH-QUALITAS, PC
Other - Org Name:ORAL SURGERY SOUTH
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VP OF HR
Authorized Official - Prefix:
Authorized Official - First Name:SUZIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FIGUEIREDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-263-9518
Mailing Address - Street 1:2 COMMERCIAL ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067
Mailing Address - Country:US
Mailing Address - Phone:401-263-9518
Mailing Address - Fax:
Practice Address - Street 1:80 WASHINGTON ST STE N-51
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1742
Practice Address - Country:US
Practice Address - Phone:401-263-9518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-10
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty