Healthcare Provider Details

I. General information

NPI: 1972395879
Provider Name (Legal Business Name): LOUIS MARK TRAPP III DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 NICHOLS RD
FITCHBURG MA
01420-1914
US

IV. Provider business mailing address

9 BALDWIN CT
HARVARD MA
01451-1516
US

V. Phone/Fax

Practice location:
  • Phone: 978-878-8100
  • Fax:
Mailing address:
  • Phone: 803-351-1592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number11074
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number11074
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number11074
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: