Jezewski, Peter Alan

Jezewski, Peter Alan is an individual health care provider with primary practice located at 100 Everett Ave Unit 5, Chelsea MA 02150. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Jezewski, Peter Alan can be contacted via phone (617) 884-4444.

Contact Information

Primary practice address
100 Everett Ave Unit 5 Chelsea MA 02150
Fax: (617) 884-4448
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X 21238 Massachusetts

Profile Details

NPI number 1730102088
LBN Legal business name Jezewski, Peter Alan
Credentials DDS PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730102088 NPPES
Massachusetts MEDICAID 0204544

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