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NPI Code Detail

MEDICARE: DR. JANICE ELIZABETH SPADA D.M.D.

MEDICARE: DR. JANICE ELIZABETH SPADA D.M.D.
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
1122300000XDentist15135MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1X06898OTHERMABLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1730182791
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JANICE ELIZABETH SPADA D.M.D.
Provider Business Mailing Address
First Line : 616 BOSTON POST RD
Second Line :
City : SUDBURY
State : MA
Zip : 01776-3376
Country : US
Telephone Number : 978-443-3111
Fax Number :
Provider Business Practice Location Address
First Line : 616 BOSTON POST RD
Second Line :
City : SUDBURY
State : MA
Zip : 01776-3376
Country : US
Telephone Number : 978-443-3111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 07/08/2007

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