Provider Demographics
NPI:1699911347
Name:ATTLEBORO-CUMBERLAND ORAL SURGEONS, INC.
Entity type:Organization
Organization Name:ATTLEBORO-CUMBERLAND ORAL SURGEONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SCHENKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:508-699-0449
Mailing Address - Street 1:103 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:02763-1015
Mailing Address - Country:US
Mailing Address - Phone:508-699-0449
Mailing Address - Fax:508-699-4344
Practice Address - Street 1:103 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:ATTLEBORO FALLS
Practice Address - State:MA
Practice Address - Zip Code:02763-1015
Practice Address - Country:US
Practice Address - Phone:508-699-0449
Practice Address - Fax:508-699-4344
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATTLEBORO-CUMBERLAND ORAL SURGEONS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-31
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213871223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty