Provider Demographics
NPI:1184718991
Name:ENDODONTIC ASSOCIATES OF CAPE COD, P.C.
Entity type:Organization
Organization Name:ENDODONTIC ASSOCIATES OF CAPE COD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:TAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-771-4320
Mailing Address - Street 1:700 ATTUCKS LN
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-1809
Mailing Address - Country:US
Mailing Address - Phone:508-771-4320
Mailing Address - Fax:508-775-4384
Practice Address - Street 1:700 ATTUCKS LN
Practice Address - Street 2:SUITE 2C
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-1809
Practice Address - Country:US
Practice Address - Phone:508-771-4320
Practice Address - Fax:508-775-4384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAX10487OtherBCBS OF MASS.