Provider Demographics
NPI:1912158130
Name:DENTAL PARTNERS OF NEWBURYPORT, LLC
Entity type:Organization
Organization Name:DENTAL PARTNERS OF NEWBURYPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:J.
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:ST. CLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-465-5358
Mailing Address - Street 1:194 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-3823
Mailing Address - Country:US
Mailing Address - Phone:978-465-5358
Mailing Address - Fax:
Practice Address - Street 1:194 HIGH ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3823
Practice Address - Country:US
Practice Address - Phone:978-465-5358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty