Bradford R Mattison Dmd PLLC
Dentist, General Practice in Wellesley, MA. Organization (NPI-2).
NPI number1477047710
StatusActive
Last updated in NPPESJun 20, 2018
Details
- NPI
- 1477047710
- Entity type
- Organization (NPI-2)
- Legal business name
- Bradford R Mattison Dmd PLLC
- Organization subpart
- No
- Enumeration date
- Jun 20, 2018
- Last updated
- Jun 20, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | DN1857389 | MA | Yes |
Other names
- Wellesley Square Dental (Doing Business As)
Practice location
1 Hollis St Ste 340Wellesley, MA 02482-4672
Phone 781-235-5404
Mailing address
115 Langley Rd # 2Newton, MA 02459-2062
Phone 617-930-6493
Authorized official
Bradford R Mattison
Owner
6179306493
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