Healthcare Provider Details

I. General information

NPI: 1831873231
Provider Name (Legal Business Name): BRIGIT DONOHUE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 E MAIN ST
NORTHBOROUGH MA
01532-1662
US

IV. Provider business mailing address

1 E MAIN ST
NORTHBOROUGH MA
01532-1662
US

V. Phone/Fax

Practice location:
  • Phone: 508-571-0358
  • Fax:
Mailing address:
  • Phone: 508-571-0358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1859896
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: