Circosta, Gary Frank

Circosta, Gary Frank is an individual health care provider with primary practice located at 93 Van Deene Ave , West Springfield MA 01089-3236. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Circosta, Gary Frank can be contacted via phone (413) 734-9400.

Contact Information

Primary practice address
93 Van Deene Ave West Springfield MA 01089-3236
Phone: (413) 734-9400
Fax: (413) 734-9408
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 11938 Massachusetts

Profile Details

NPI number 1316935448
LBN Legal business name Circosta, Gary Frank
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316935448 NPPES
Massachusetts MEDICAID 0209821

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