Provider Demographics
NPI:1215945217
Name:MERRIMACK VALLEY ENDODONTICS LLP
Entity type:Organization
Organization Name:MERRIMACK VALLEY ENDODONTICS LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:ZVI
Authorized Official - Last Name:GILAD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-251-1515
Mailing Address - Street 1:73 PRINCETON ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863
Mailing Address - Country:US
Mailing Address - Phone:978-251-1515
Mailing Address - Fax:978-251-1616
Practice Address - Street 1:73 PRINCETON ST
Practice Address - Street 2:SUITE 202
Practice Address - City:NORTH CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863
Practice Address - Country:US
Practice Address - Phone:978-251-1515
Practice Address - Fax:978-251-1616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA187521223E0200X
MA187721223E0200X
MA166001223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty