| Northgate Dental Center, PC | |
|
1985 Main St Ste 1 Springfield MA 01103-1072 | |
| (413) 747-0400 | |
| (413) 747-2440 |
| Full Name | Northgate Dental Center, PC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1985 Main St Ste 1, Springfield, Massachusetts |
| Authorized Official Name and Position | William Malave-vidal (PRESIDENT) |
| Authorized Official Contact | 4137470400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northgate Dental Center, PC Po Box 2218 Springfield MA 01101-2218 Ph: (413) 747-0400 | Northgate Dental Center, PC 1985 Main St Ste 1 Springfield MA 01103-1072 Ph: (413) 747-0400 |
| NPI Number | 1275665705 |
|---|---|
| Provider Enumeration Date | 03/11/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275665705 | NPI | - | NPPES |
| 9753371 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 18100 (Massachusetts) | Primary |
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