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NPI Code Detail

MEDICARE: MITCHELL PASENKOFF, DMD

MEDICARE: MITCHELL PASENKOFF, 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
1261QD0000XDental Clinic/Center16711MA

General Provider Information

NPI Number : 1669666913
Entity Type Code : Organization
Provider Name (Legal Business Name) : MITCHELL PASENKOFF, DMD
Provider Business Mailing Address
First Line : 146 MAIN ST
Second Line : SUITE 2A
City : NORFOLK
State : MA
Zip : 02056-1322
Country : US
Telephone Number : 508-528-5351
Fax Number :
Provider Business Practice Location Address
First Line : 146 MAIN ST
Second Line : SUITE 2A
City : NORFOLK
State : MA
Zip : 02056-1322
Country : US
Telephone Number : 508-528-5351
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. MITCHELL STUART PASENKOFF
Credential : D.M.D.
Telephone Number : 508-528-5351
Provider Enumeration Date : 08/30/2007
Last Update Date : 08/30/2007

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Directions to “MITCHELL PASENKOFF, DMD ” Practice Location

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