Healthcare Provider Details

I. General information

NPI: 1912014432
Provider Name (Legal Business Name): DR. SANDRA TRANFAGLIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SANDRA TRAFAGLIA DMD PC

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 WASHINGTON ST
SOMERVILLE MA
02143
US

IV. Provider business mailing address

17 WASHINGTON ST
SOMERVILLE MA
02143
US

V. Phone/Fax

Practice location:
  • Phone: 617-628-2006
  • Fax: 617-628-2007
Mailing address:
  • Phone: 617-628-2006
  • Fax: 617-628-2007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number19406
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: