Provider Demographics
NPI:1548316326
Name:PETER C. NIARHOS DMD
Entity type:Organization
Organization Name:PETER C. NIARHOS DMD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:C
Authorized Official - Last Name:NIARHOS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-454-8221
Mailing Address - Street 1:1794 BRIDGE ST
Mailing Address - Street 2:SUITE 22A
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-2673
Mailing Address - Country:US
Mailing Address - Phone:978-454-8221
Mailing Address - Fax:978-446-0911
Practice Address - Street 1:1794 BRIDGE ST
Practice Address - Street 2:SUITE 22A
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-2673
Practice Address - Country:US
Practice Address - Phone:978-454-8221
Practice Address - Fax:978-446-0911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA173031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty