Provider Demographics
NPI:1134274913
Name:METHUEN ORAL SURGERY ASSOCIATES, P.C.
Entity type:Organization
Organization Name:METHUEN ORAL SURGERY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL AND MAXILLOFACIAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:GRZEJKA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-687-2224
Mailing Address - Street 1:60 EAST ST
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-4500
Mailing Address - Country:US
Mailing Address - Phone:978-687-2224
Mailing Address - Fax:978-683-2191
Practice Address - Street 1:60 EAST ST
Practice Address - Street 2:SUITE 2500
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-4500
Practice Address - Country:US
Practice Address - Phone:978-687-2224
Practice Address - Fax:978-683-2191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16054201223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA798600OtherTUFTS
MAX07726OtherBLUE CROSS BLUE SHIELD
MA1588759237OtherNPI
MA798600OtherTUFTS