Provider Demographics
NPI:1144389420
Name:SMAGULA, JAMIE MICHAEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:MICHAEL
Last Name:SMAGULA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 LITTLETON RD
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886
Mailing Address - Country:US
Mailing Address - Phone:978-692-7563
Mailing Address - Fax:978-692-9469
Practice Address - Street 1:200 LITTLETON RD
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886
Practice Address - Country:US
Practice Address - Phone:978-692-7563
Practice Address - Fax:978-692-9469
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA210781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice