Provider Demographics
NPI:1164523379
Name:DRS. THOMAS AND KIRVIN P.C.
Entity Type:Organization
Organization Name:DRS. THOMAS AND KIRVIN P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:KIRVIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:413-532-7183
Mailing Address - Street 1:536 GRATTAN ST
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-1545
Mailing Address - Country:US
Mailing Address - Phone:413-532-7183
Mailing Address - Fax:413-534-7447
Practice Address - Street 1:536 GRATTAN ST
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-1545
Practice Address - Country:US
Practice Address - Phone:413-532-7183
Practice Address - Fax:413-534-7447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA174281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty