Provider Demographics
NPI:1821310657
Name:MICRO ENDODONTICS LLC
Entity Type:Organization
Organization Name:MICRO ENDODONTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUAY
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRASS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-365-6091
Mailing Address - Street 1:11 CHESTNUT ST STE 9
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-3724
Mailing Address - Country:US
Mailing Address - Phone:978-475-8008
Mailing Address - Fax:978-475-9990
Practice Address - Street 1:11 CHESTNUT ST STE 9
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3724
Practice Address - Country:US
Practice Address - Phone:978-475-8008
Practice Address - Fax:978-475-9990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-21
Last Update Date:2020-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1427119403OtherNPI
1588076269OtherNPI
1497010292OtherNPI