| St.joseph's Family Dental,llc | |
|
258 Main St West Springfield MA 01089-3955 | |
| (413) 737-3181 | |
| (413) 737-3184 |
| Full Name | St.joseph's Family Dental,llc |
|---|---|
| Speciality | Dentist |
| Location | 258 Main St, West Springfield, Massachusetts |
| Authorized Official Name and Position | Susana R Aguero (DENTIST) |
| Authorized Official Contact | 4137373181 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St.joseph's Family Dental,llc 258 Main St West Springfield MA 01089-3955 Ph: (413) 737-3181 | St.joseph's Family Dental,llc 258 Main St West Springfield MA 01089-3955 Ph: (413) 737-3181 |
| NPI Number | 1003143157 |
|---|---|
| Provider Enumeration Date | 11/11/2009 |
| Last Update Date | 11/11/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003143157 | NPI | - | NPPES |
| 110076716B | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 21492 (Massachusetts) | Primary |
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