Provider Demographics
NPI:1891019741
Name:BRIAN F. DALTON DDS PC
Entity type:Organization
Organization Name:BRIAN F. DALTON DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:DALTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:781-592-1650
Mailing Address - Street 1:15 POST OFFICE SQUARE
Mailing Address - Street 2:LYNNFIELD MEDCAL BUILDING
Mailing Address - City:LYNNFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01940
Mailing Address - Country:US
Mailing Address - Phone:781-592-1650
Mailing Address - Fax:
Practice Address - Street 1:15 POST OFFICE SQUARE
Practice Address - Street 2:LYNNFIELD MEDCAL BUILDING
Practice Address - City:LYNNFIELD
Practice Address - State:MA
Practice Address - Zip Code:01940
Practice Address - Country:US
Practice Address - Phone:781-592-1650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-22
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA123131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty