| Organization Name: | PROSTHODONTICS, P.C. |
| NPI Number: | 1053517037 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY-LOU COURCELLE (OFFICE MANAGER) |
| Mailing Address: | 16 Enon St Beverly |
| State: | MA US |
| Postal Code: | 019151116 |
| Phone Number: | 9789226726 |
| Fax Number: | 9789226727 |
| NPI Enumeration Date: | 06/26/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0700X |
| License Number: | 17559 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Prosthodontics |
| Taxonomy Definition: | That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |