Pennacchio, Evelyn A
Pennacchio, Evelyn A is an individual health care provider with primary practice located at 16 Pleasant St , Revere MA 02151. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Pennacchio, Evelyn A can be contacted via phone (781) 286-2800.Contact Information
Primary practice address
16 Pleasant St
Revere MA 02151
Phone: (781) 286-2800
Fax: (781) 289-5959
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 16540 | Massachusetts |
Profile Details
| NPI number | 1083721690 |
|---|---|
| LBN Legal business name | Pennacchio, Evelyn A |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 23rd, 2006 |
| 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083721690 | NPPES |
| Massachusetts | Other | X05936 | BCBS |
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