Provider Demographics
NPI:1548327604
Name:MANDELL, ROBERT LINDSAY (DM D , MMSC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LINDSAY
Last Name:MANDELL
Suffix:
Gender:M
Credentials:DM D , MMSC
Other - Prefix:
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Mailing Address - Street 1:441 LOWELL ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-1533
Mailing Address - Country:US
Mailing Address - Phone:781-942-0190
Mailing Address - Fax:781-944-5258
Practice Address - Street 1:164 WESTFORD RD
Practice Address - Street 2:SUITE 8
Practice Address - City:TYNGSBORO
Practice Address - State:MA
Practice Address - Zip Code:01879-2530
Practice Address - Country:US
Practice Address - Phone:978-649-3058
Practice Address - Fax:978-649-9566
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA133061223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics