Basic Information
| Provider Information | |||||||||
| NPI: | 1376649822 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BILLIA | ||||||||
| FirstName: | PETER | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | D.M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 326 NICHOLS ROAD | ||||||||
| Address2: | |||||||||
| City: | FITCHBURG | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9788788516 | ||||||||
| FaxNumber: | 9788788418 | ||||||||
| Practice Location | |||||||||
| Address1: | 326 NICHOLS ROAD | ||||||||
| Address2: | |||||||||
| City: | FITCHBURG | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9788788100 | ||||||||
| FaxNumber: | 9788788326 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2006 | ||||||||
| LastUpdateDate: | 08/17/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 14386 | MA | Y | Dental Providers | Dentist | General Practice |
No ID Information.