<Unavail>

LBN: Ian E Modestow, Dmd
<Unavail> is an health care organization with primary practice located at 190 Nonotuck St Suite 101, Florence MA 01062-1962. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Ian E Modestow, Dmd can be contacted via phone (413) 586-5887, or through Kersbergen, Michelle via phone (413) 586-5887.

Contact Information

Primary practice address
190 Nonotuck St Suite 101 Florence MA 01062-1962
Phone: (413) 586-5887
Fax: (413) 584-9478
Website:
Map and Directions
Authorized official contact:
Name: Kersbergen, Michelle
Phone: (413) 586-5887

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DN20017 Massachusetts

Profile Details

NPI number 1083902266
LBN Legal business name Ian E Modestow, Dmd
DBA Doing business as <Unavail>
Authorized official Kersbergen, Michelle
Entity Organization
Organization subpart 1 No
Enumeration date Jul 21st, 2011
Last updated Jul 21st, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083902266 NPPES
Massachusetts Other DN20017 BOARD OF REGISTRATION
Massachusetts Other DN13648 BOARD OF REGISTRATION

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