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NPI Code Detail

MEDICARE: GRACE DONOGHUE DMD

MEDICARE: GRACE DONOGHUE DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry16024MA

General Provider Information

NPI Number : 1326076423
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE DONOGHUE DMD
Provider Business Mailing Address
First Line : 81 WEST ST
Second Line :
City : LEOMINSTER
State : MA
Zip : 01453-5649
Country : US
Telephone Number : 978-534-9216
Fax Number : 978-537-6931
Provider Business Practice Location Address
First Line : 81 WEST ST
Second Line :
City : LEOMINSTER
State : MA
Zip : 01453-5649
Country : US
Telephone Number : 978-534-9216
Fax Number : 978-537-6931
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2006
Last Update Date : 07/08/2007

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Directions to “ GRACE DONOGHUE DMD” Practice Location

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