Northgate Dental Center, Pc | |
1985 Main St Ste 1 Springfield MA 01103-1072 | |
(413) 747-0400 | |
(413) 747-2440 |
Full Name | Northgate Dental Center, Pc |
---|---|
Speciality | Dentist - General Practice |
Location | 1985 Main St Ste 1, Springfield, Massachusetts |
Authorized Official Name and Position | William Malave-vidal (PRESIDENT) |
Authorized Official Contact | 4137470400 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Northgate Dental Center, Pc Po Box 2218 Springfield MA 01101-2218 Ph: (413) 747-0400 | Northgate Dental Center, Pc 1985 Main St Ste 1 Springfield MA 01103-1072 Ph: (413) 747-0400 |
NPI Number | 1275665705 |
---|---|
Provider Enumeration Date | 03/11/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275665705 | NPI | - | NPPES |
9753371 | Medicaid | MA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 18100 (Massachusetts) | Primary |
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