Provider Demographics
NPI:1760870232
Name:SCITUATE FAMILY DENTISTRY, INC
Entity Type:Organization
Organization Name:SCITUATE FAMILY DENTISTRY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-545-3703
Mailing Address - Street 1:56 NEW DRIFTWAY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-4533
Mailing Address - Country:US
Mailing Address - Phone:781-545-3703
Mailing Address - Fax:781-545-0772
Practice Address - Street 1:56 NEW DRIFTWAY
Practice Address - Street 2:SUITE 205
Practice Address - City:SCITUATE
Practice Address - State:MA
Practice Address - Zip Code:02066-4533
Practice Address - Country:US
Practice Address - Phone:781-545-3703
Practice Address - Fax:781-545-0772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-06
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN15759208D00000X
NYDN22290208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty