Healthcare Provider Details

I. General information

NPI: 1720906167
Provider Name (Legal Business Name): ADMIRE DENTAL OF SPRINGFIELD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 STATE ST
SPRINGFIELD MA
01105-1320
US

IV. Provider business mailing address

305 STATE ST
SPRINGFIELD MA
01105-1320
US

V. Phone/Fax

Practice location:
  • Phone: 413-232-9022
  • Fax:
Mailing address:
  • Phone: 413-232-9022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MAGGIE MCCLAIN
Title or Position: TRANSITIONS MANAGER
Credential:
Phone: 860-269-0628