Provider Demographics
NPI:1609909084
Name:SPINALE MOYNIHAN DMD PC
Entity Type:Organization
Organization Name:SPINALE MOYNIHAN DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEPF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-879-8250
Mailing Address - Street 1:130 MAYNARD RD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-2504
Mailing Address - Country:US
Mailing Address - Phone:508-879-8250
Mailing Address - Fax:508-626-9914
Practice Address - Street 1:130 MAYNARD RD
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-2504
Practice Address - Country:US
Practice Address - Phone:508-879-8250
Practice Address - Fax:508-626-9914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA96901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty