Provider Demographics
NPI:1366024275
Name:BARBOZA M LIMOEIRO, DIEGO (DDSDS)
Entity Type:Individual
Prefix:DR
First Name:DIEGO
Middle Name:
Last Name:BARBOZA M LIMOEIRO
Suffix:
Gender:M
Credentials:DDSDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 GLEN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-2826
Mailing Address - Country:US
Mailing Address - Phone:802-770-1730
Mailing Address - Fax:
Practice Address - Street 1:135 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-3238
Practice Address - Country:US
Practice Address - Phone:802-770-1730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2023-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL14743122300000X
VT016.0134154122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist