Dr. John Michael Ristuccia
Oral and Maxillofacial Surgeon
46 Balsam St
Fairhaven
, Massachusetts 02719-7045
Dr. John Michael Ristuccia
Oral and Maxillofacial Surgeon
46 Balsam St
Fairhaven
, Massachusetts 02719-7045
(508) 999-6098
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. John Michael Ristuccia
- 46 Balsam St
- Fairhaven, MA
- Zip : 02719-7045
- Phone : (508) 999-6098
Second Address
- Dr. John Michael Ristuccia
- 46 Balsam St
- Fairhaven, MA
- Zip : 02719-7045
- Phone : (508) 999-6098
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | 11590 | MA |
National Provider Identifier
| NPI | 1023173788 |
|---|---|
| Provider Name | Dr. John Michael Ristuccia |
| First Address | Fairhaven, MA 02719-7045 |
| Second Address | Fairhaven, MA 02719-7045 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/12/2006 |
| Last Update Date | 21/10/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| T90135 | (02) | MA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.