Provider Demographics
NPI:1386719334
Name:HINGHAM ENDODONTICS, INC.
Entity type:Organization
Organization Name:HINGHAM ENDODONTICS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:DOLBEC
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:781-749-1119
Mailing Address - Street 1:210 WHITING STREET
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043
Mailing Address - Country:US
Mailing Address - Phone:781-749-1119
Mailing Address - Fax:781-740-8033
Practice Address - Street 1:210 WHITING STREET
Practice Address - Street 2:SUITE 2
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043
Practice Address - Country:US
Practice Address - Phone:781-749-1119
Practice Address - Fax:781-740-8033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA164031223E0200X
MA106011223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty