Healthcare Provider Details

I. General information

NPI: 1942748595
Provider Name (Legal Business Name): NORFOLK FAMILY & PEDIATRIC DENTISTRY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2017
Last Update Date: 02/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 HOLBROOK ST SUITE 210
NORFOLK MA
02056-1848
US

IV. Provider business mailing address

65 HOLBROOK ST SUITE 210
NORFOLK MA
02056-1848
US

V. Phone/Fax

Practice location:
  • Phone: 781-806-0989
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN1856886
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDN1856887
License Number StateMA

VIII. Authorized Official

Name: DR. MINDA R SAPIR
Title or Position: CEO
Credential: DMD
Phone: 516-306-4738