Provider Demographics
NPI:1932359734
Name:MASTERPIECE DENTISTRY AT COPLEY
Entity type:Organization
Organization Name:MASTERPIECE DENTISTRY AT COPLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:PAPPAS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-266-6020
Mailing Address - Street 1:441 STUART ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-5019
Mailing Address - Country:US
Mailing Address - Phone:617-266-6020
Mailing Address - Fax:617-266-0802
Practice Address - Street 1:441 STUART ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-5019
Practice Address - Country:US
Practice Address - Phone:617-266-6020
Practice Address - Fax:617-266-0802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA208111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty