Provider Demographics
NPI:1285721993
Name:MIDDLETON DENTAL CARE, PC
Entity type:Organization
Organization Name:MIDDLETON DENTAL CARE, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DIMAURO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:978-777-8722
Mailing Address - Street 1:100 S MAIN ST
Mailing Address - Street 2:SUITE 100 B
Mailing Address - City:MIDDLETON
Mailing Address - State:MA
Mailing Address - Zip Code:01949-2211
Mailing Address - Country:US
Mailing Address - Phone:978-777-8722
Mailing Address - Fax:978-777-9223
Practice Address - Street 1:100 S MAIN ST
Practice Address - Street 2:SUITE 100 B
Practice Address - City:MIDDLETON
Practice Address - State:MA
Practice Address - Zip Code:01949-2211
Practice Address - Country:US
Practice Address - Phone:978-777-8722
Practice Address - Fax:978-777-9223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17035122300000X
MA16547122300000X
MA209121223E0200X
MA167191223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered122300000XDental ProvidersDentistGroup - Multi-Specialty
Not Answered1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
Not Answered1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty