Provider Demographics
NPI:1942748595
Name:NORFOLK FAMILY & PEDIATRIC DENTISTRY INC
Entity Type:Organization
Organization Name:NORFOLK FAMILY & PEDIATRIC DENTISTRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MINDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:SAPIR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:516-306-4738
Mailing Address - Street 1:65 HOLBROOK ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:NORFOLK
Mailing Address - State:MA
Mailing Address - Zip Code:02056-1848
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:65 HOLBROOK ST
Practice Address - Street 2:SUITE 210
Practice Address - City:NORFOLK
Practice Address - State:MA
Practice Address - Zip Code:02056-1848
Practice Address - Country:US
Practice Address - Phone:781-806-0989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18568861223G0001X
MADN18568871223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty