Healthcare Provider Details
I. General information
NPI: 1740298504
Provider Name (Legal Business Name): DAVID MITCHELL SINGER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5 LONGFELLOW PLACE SUITE 205
BOSTON MA
02114
US
IV. Provider business mailing address
50 SALEM ST BLDG A
LYNNFIELD MA
01940
US
V. Phone/Fax
- Phone: 617-742-3525
- Fax: 617-742-6911
- Phone: 781-245-8828
- Fax: 781-224-1158
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223E0200X |
| Taxonomy | Endodontics |
| License Number | 19472 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: