Provider Demographics
NPI:1639441942
Name:DR DENTAL OF LOWELL
Entity Type:Organization
Organization Name:DR DENTAL OF LOWELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FAIGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-232-2266
Mailing Address - Street 1:861 HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-5419
Mailing Address - Country:US
Mailing Address - Phone:603-232-2266
Mailing Address - Fax:603-232-2278
Practice Address - Street 1:1235 BRIDGE ST
Practice Address - Street 2:SUNRISE SHOPPING CENTER
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01850-1254
Practice Address - Country:US
Practice Address - Phone:603-232-2266
Practice Address - Fax:603-232-2278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty