Provider Demographics
NPI:1083721112
Name:CALSIMITTO, DONNA LOUISE (DMD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:LOUISE
Last Name:CALSIMITTO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 LONDON ST
Mailing Address - Street 2:
Mailing Address - City:EAST BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02128
Mailing Address - Country:US
Mailing Address - Phone:617-567-3537
Mailing Address - Fax:617-568-9077
Practice Address - Street 1:123 LONDON ST
Practice Address - Street 2:
Practice Address - City:EAST BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128
Practice Address - Country:US
Practice Address - Phone:617-568-9077
Practice Address - Fax:617-568-9077
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA131541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0247332OtherMASS HEALTH