Provider Demographics
NPI:1790291664
Name:BITE SIZE DENTAL CARE
Entity Type:Organization
Organization Name:BITE SIZE DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:MOYNIHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:774-333-8080
Mailing Address - Street 1:16D MACYS LN
Mailing Address - Street 2:
Mailing Address - City:NANTUCKET
Mailing Address - State:MA
Mailing Address - Zip Code:02554-2831
Mailing Address - Country:US
Mailing Address - Phone:774-333-8080
Mailing Address - Fax:508-901-5584
Practice Address - Street 1:16D MACYS LN
Practice Address - Street 2:
Practice Address - City:NANTUCKET
Practice Address - State:MA
Practice Address - Zip Code:02554-2831
Practice Address - Country:US
Practice Address - Phone:774-333-8080
Practice Address - Fax:508-901-5584
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MICHAEL F. MOYNIHAN, DMD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-14
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA189981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty