Provider Demographics
NPI:1346302205
Name:PAIGE, CHRISTINE VICTORIA (DMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:VICTORIA
Last Name:PAIGE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-1907
Mailing Address - Country:US
Mailing Address - Phone:781-843-0660
Mailing Address - Fax:781-843-4364
Practice Address - Street 1:60 ADAMS ST
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184
Practice Address - Country:US
Practice Address - Phone:781-843-0660
Practice Address - Fax:781-843-4364
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA142121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAX10267OtherBLUE CROSS BLUE SHIELD