| Facial Cosmetic & Maxillofacial Surgery P.c. | |
|
382 N Main St Suite 202 East Longmeadow MA 01028-1828 | |
| (413) 525-0100 | |
| (413) 525-8608 |
| Full Name | Facial Cosmetic & Maxillofacial Surgery P.c. |
|---|---|
| Speciality | Dentist |
| Location | 382 N Main St, East Longmeadow, Massachusetts |
| Authorized Official Name and Position | Richard J Fraziero (PRESIDENT) |
| Authorized Official Contact | 4135250100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Facial Cosmetic & Maxillofacial Surgery P.c. 382 N Main St Suite 202 East Longmeadow MA 01028-1828 Ph: (413) 525-0100 | Facial Cosmetic & Maxillofacial Surgery P.c. 382 N Main St Suite 202 East Longmeadow MA 01028-1828 Ph: (413) 525-0100 |
| NPI Number | 1417155276 |
|---|---|
| Provider Enumeration Date | 07/03/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3072584853 |
|---|---|
| Medicare Enrollment ID | O20040804001241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417155276 | NPI | - | NPPES |
| 0272167 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 016684 (Massachusetts) | Primary |
| Provider Name | Richard J Fraziero |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1053321190 PECOS PAC ID: 8921079724 Enrollment ID: I20040806001067 |
| Provider Name | Michael Jay Spink |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1275744310 PECOS PAC ID: 7214077890 Enrollment ID: I20091211000283 |
| Provider Name | Justin B Clemow |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1952504219 PECOS PAC ID: 6002050432 Enrollment ID: I20150911000104 |
| Provider Name | Max Kernizan |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1811334493 PECOS PAC ID: 9739461161 Enrollment ID: I20171030001482 |
| Provider Name | Michael William Courtney |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1144576240 PECOS PAC ID: 4284866658 Enrollment ID: I20180403001774 |
| Provider Name | Steven D Nguyen |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1932488152 PECOS PAC ID: 0446505044 Enrollment ID: I20180622001871 |
Thaida Duong, Dmd, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 Pleasant St, East Longmeadow, MA 01028 Phone: 413-525-0955 | |
Raymond D.manniello,d.d.s.,p.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 264 N Main St, Suite 4, East Longmeadow, MA 01028 Phone: 413-525-0861 | |
Ascent Dental Care Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 250 N Main St, East Longmeadow, MA 01028 Phone: 413-224-1493 Fax: 413-224-1746 | |
Facial Cosmetics & Maxillofacial Surgery Dental Clinic Medicare: Medicare Enrolled Practice Location: 382 N Main St Ste 202, East Longmeadow, MA 01028 Phone: 413-525-0100 Fax: 413-525-8608 | |
Maple Dental Associates Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 79 Maple St, East Longmeadow, MA 01028 Phone: 413-525-6821 Fax: 413-525-5280 | |
Patrick Dermesropian, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 434 N Main St, Suite 110, East Longmeadow, MA 01028 Phone: 413-526-9901 Fax: 413-526-9921 | |
Alliance Dental Care Of East Longmeadow Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 265a Benton Dr, East Longmeadow, MA 01028 Phone: 413-224-8590 |