Provider Demographics
NPI:1982729067
Name:DORES, JAMES E (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:DORES
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 1:175 DWIGHT RD STE 304
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-1767
Mailing Address - Country:US
Mailing Address - Phone:413-567-3170
Mailing Address - Fax:413-567-0575
Practice Address - Street 1:175 DWIGHT RD STE 304
Practice Address - Street 2:
Practice Address - City:LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01106-1767
Practice Address - Country:US
Practice Address - Phone:413-567-3170
Practice Address - Fax:413-567-0575
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA215331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAV06380OtherBCBS OF MA
MA0188OtherDELTA DENTAL
MAX10693OtherBCBS OF MA GROUP