Fantoni, Amy B
Fantoni, Amy B is an individual health care provider with primary practice located at 670 W Boylston St , Worcester MA 01606-2064. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Fantoni, Amy B can be contacted via phone (508) 854-7548.Contact Information
Primary practice address
670 W Boylston St
Worcester MA 01606-2064
Phone: (508) 854-7548
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Hygienist | 124Q00000X | 8559 | Massachusetts |
Profile Details
| NPI number | 1184860850 |
|---|---|
| LBN Legal business name | Fantoni, Amy B |
| Credentials | Registered Dental Hygienist (RDH) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 30th, 2008 |
| Last updated | Dec 30th, 2008 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184860850 | NPPES |
| Massachusetts | Other | 1301071 | MEDICAID GROUP # |
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