OrganizationActive
Aesthetic Smile Reconstruction PC
NPI 1437621224 · Dental Clinic/Center · Waltham, MA
Provider details
- NPI number
- 1437621224
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Charles Sutera, President(978) 314-8974
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(67/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
75 3rd Ave Ste 1b
Waltham, MA 02451-7549
Phone: (781) 487-1111
Street-level locationGet directions
Mailing address
20 Roosevelt Rd
Medford, MA 02155-2519
Other names (DBA / former)
- Doing business as
- Aesthetic Smile Reconstruction
Registry dates
- Enumerated
- 2018-12-18
- Last updated
- 2018-12-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.