Provider Demographics
NPI:1336203850
Name:ARCH ORTHODONTICS
Entity Type:Organization
Organization Name:ARCH ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MUGHERINI
Authorized Official - Suffix:
Authorized Official - Credentials:CDA
Authorized Official - Phone:508-584-1166
Mailing Address - Street 1:348 N PEARL ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-1197
Mailing Address - Country:US
Mailing Address - Phone:508-584-1166
Mailing Address - Fax:
Practice Address - Street 1:348 N PEARL ST
Practice Address - Street 2:SUITE 3
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-1197
Practice Address - Country:US
Practice Address - Phone:508-584-1166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA203251223X0400X
MA215431223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty