Provider Demographics
NPI:1417294349
Name:SINNOTT, MOIRA K (DMD)
Entity Type:Individual
Prefix:
First Name:MOIRA
Middle Name:K
Last Name:SINNOTT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 LEDGEVIEW WAY APT 1120
Mailing Address - Street 2:
Mailing Address - City:WRENTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02093-1916
Mailing Address - Country:US
Mailing Address - Phone:978-760-2510
Mailing Address - Fax:
Practice Address - Street 1:104 DEAN ST STE 103
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-5403
Practice Address - Country:US
Practice Address - Phone:508-692-9548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-11
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN2228282-A1223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0004XDental ProvidersDentistDentist AnesthesiologistGroup - Single Specialty