Provider Demographics
NPI:1942443932
Name:SPRINGFIELD FAMILY DENTAL
Entity Type:Organization
Organization Name:SPRINGFIELD FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FAIGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-753-9200
Mailing Address - Street 1:800 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01119-1311
Mailing Address - Country:US
Mailing Address - Phone:413-796-4700
Mailing Address - Fax:413-796-4708
Practice Address - Street 1:800 BOSTON RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01119-1311
Practice Address - Country:US
Practice Address - Phone:413-796-4700
Practice Address - Fax:413-796-4708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty