Provider Demographics
NPI:1750867032
Name:PAXTON DENTAL CARE PC
Entity Type:Organization
Organization Name:PAXTON DENTAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:SIEMEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-557-2400
Mailing Address - Street 1:672 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:PAXTON
Mailing Address - State:MA
Mailing Address - Zip Code:01612-1306
Mailing Address - Country:US
Mailing Address - Phone:508-791-6140
Mailing Address - Fax:
Practice Address - Street 1:672 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:PAXTON
Practice Address - State:MA
Practice Address - Zip Code:01612-1306
Practice Address - Country:US
Practice Address - Phone:508-557-2400
Practice Address - Fax:508-791-3628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-19
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty