Provider Demographics
NPI:1942664727
Name:NAVEO, DALBA E
Entity Type:Individual
Prefix:
First Name:DALBA
Middle Name:E
Last Name:NAVEO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 OSGOOD ST APT R209
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-3006
Mailing Address - Country:US
Mailing Address - Phone:978-885-6083
Mailing Address - Fax:
Practice Address - Street 1:51 OSGOOD ST APT R209
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-3006
Practice Address - Country:US
Practice Address - Phone:978-885-6083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-07
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADA07390126800000X
MADL128901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No126800000XDental ProvidersDental Assistant