Phoenix PC

General Practice Dentistry · Brockton, MA

Organization Active NPI

NPI number 1275720971

Practice location

165 Westgate Dr
Brockton, MA 02301-1821
Phone
(781) 335-8355

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NPI record

NPI
1275720971
Entity type
Organization (Type 2)
Enumeration date
September 27, 2007
Last updated
September 27, 2007
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 13263 MA

Mailing address

281 Sanders Creek Pkwy
East Syracuse, NY 13057-1307
Phone
(315) 454-6000

Authorized official

Name
Peter Mortelliti
Title
Owner
Phone
(315) 454-6000

About Phoenix PC

Phoenix PC is a healthcare organization registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 165 Westgate Dr, Brockton, MA 02301-1821. The NPI number 1275720971 was assigned on September 27, 2007 and the record was last updated on September 27, 2007.

Phoenix PC lists a license in the registry: #13263 (MA) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Peter Mortelliti, Owner.

Frequently asked questions

What is the NPI number of Phoenix PC?

The NPI number is 1275720971.

What is the phone number of Phoenix PC?

The phone number listed for the practice location is (781) 335-8355.

Where is Phoenix PC located?

165 Westgate Dr, Brockton, MA 02301-1821.

What is the taxonomy code for Phoenix PC?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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