Provider Demographics
NPI:1750575551
Name:PAUL A. LAROCQUE, D.M.D
Entity type:Organization
Organization Name:PAUL A. LAROCQUE, D.M.D
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAROCQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-544-7965
Mailing Address - Street 1:450 W RIVER ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ORANGE
Mailing Address - State:MA
Mailing Address - Zip Code:01364-1435
Mailing Address - Country:US
Mailing Address - Phone:978-544-7965
Mailing Address - Fax:978-544-2922
Practice Address - Street 1:450 W RIVER ST
Practice Address - Street 2:SUITE 2
Practice Address - City:ORANGE
Practice Address - State:MA
Practice Address - Zip Code:01364-1435
Practice Address - Country:US
Practice Address - Phone:978-544-7965
Practice Address - Fax:978-544-2922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty