Healthcare Provider Details

I. General information

NPI: 1639151061
Provider Name (Legal Business Name): CARA L DONLEY D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327B BOSTON POST RD
SUDBURY MA
01776-3001
US

IV. Provider business mailing address

45 MEADOWBROOK CIR
SUDBURY MA
01776-2641
US

V. Phone/Fax

Practice location:
  • Phone: 978-443-8833
  • Fax: 978-443-8843
Mailing address:
  • Phone: 978-443-2108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number19854
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: