Provider Demographics
NPI:1649385543
Name:MAGIERA, CHRISTOPHER J (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:MAGIERA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SILVER ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:AGAWAM
Mailing Address - State:MA
Mailing Address - Zip Code:01001-2916
Mailing Address - Country:US
Mailing Address - Phone:413-786-0171
Mailing Address - Fax:413-786-2368
Practice Address - Street 1:200 SILVER ST
Practice Address - Street 2:SUITE 205
Practice Address - City:AGAWAM
Practice Address - State:MA
Practice Address - Zip Code:01001-2916
Practice Address - Country:US
Practice Address - Phone:413-786-0171
Practice Address - Fax:413-786-2368
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA189731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAX07492OtherBLUE CROSS BLUE SHIELD MA