Provider Demographics
NPI:1205810892
Name:DONOHUE & DONOHUE DMD, PC
Entity type:Organization
Organization Name:DONOHUE & DONOHUE DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:DONOHUE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:413-737-7912
Mailing Address - Street 1:624 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01108-2443
Mailing Address - Country:US
Mailing Address - Phone:413-737-7912
Mailing Address - Fax:413-734-6296
Practice Address - Street 1:624 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01108-2443
Practice Address - Country:US
Practice Address - Phone:413-737-7912
Practice Address - Fax:413-734-6296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA148761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA420114OtherUNITED CONCORDIA
CT020014876MA-01OtherBCBS CT
RI05029OtherDELTADENTAL RI
MAX05069OtherBCBS MA