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General NPI Number Information
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NPI Number | 1396916060
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Entity Type | Organization
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Legal Business Name | DININNO FAMILY DENTAL, INC.
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Dates
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Enumeration Date | 03/20/2008
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Last Update Date | 01/28/2016
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Provider Practice Location Address
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Address Line | 931 SOUTH ST
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City | FITCHBURG
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State | MA
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Zip | 01420-7019
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Country | US
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Telephone | 978-342-8710
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Fax |
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Provider Business Mailing Address
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Address Line | 931 SOUTH ST
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City | FITCHBURG
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State | MA
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Zip | 01420-7019
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Country | US
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Telephone | 978-342-8710
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NICHOLAS J. DININNO III
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Credential | DMD
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Telephone | 978-342-8710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 13917
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN1855976
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License Number State | MA
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