Provider Demographics
NPI:1154662138
Name:TRIMBOLI, VINCENT A JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:A
Last Name:TRIMBOLI
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-2321
Mailing Address - Country:US
Mailing Address - Phone:413-537-0430
Mailing Address - Fax:
Practice Address - Street 1:52 N MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-2321
Practice Address - Country:US
Practice Address - Phone:413-537-0430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17445122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist