Provider Demographics
NPI:1275879850
Name:FRANK MICHITTI, DDS, PC
Entity Type:Organization
Organization Name:FRANK MICHITTI, DDS, PC
Other - Org Name:LIFETIME DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHITTI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:860-255-7162
Mailing Address - Street 1:1156 SPRINGFIELD ST
Mailing Address - Street 2:
Mailing Address - City:FEEDING HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:01030-2185
Mailing Address - Country:US
Mailing Address - Phone:413-786-4400
Mailing Address - Fax:
Practice Address - Street 1:1156 SPRINGFIELD ST
Practice Address - Street 2:
Practice Address - City:FEEDING HILLS
Practice Address - State:MA
Practice Address - Zip Code:01030-2185
Practice Address - Country:US
Practice Address - Phone:413-786-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-30
Last Update Date:2012-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18561281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty