Provider Demographics
NPI:1154461846
Name:MCGONIGLE, CHRISTOPHER THOMAS (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:THOMAS
Last Name:MCGONIGLE
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 1:388 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-1945
Mailing Address - Country:US
Mailing Address - Phone:781-272-2875
Mailing Address - Fax:781-270-9101
Practice Address - Street 1:388 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-1945
Practice Address - Country:US
Practice Address - Phone:781-272-2875
Practice Address - Fax:781-270-9101
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA208651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice