Organization
FACIAL COSMETIC & MAXILLOFACIAL SURGERY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD J FRAZIERO DMD F.A.D.S.A (PRESIDENT)
(413) 525-0100
Entity
Organization
Contact information
Practice address
382 N MAIN ST, SUITE 202, EAST LONGMEADOW, MA 01028-1828
(413) 525-0100
(413) 525-8608
Mailing address
382 N MAIN ST, SUITE 202, EAST LONGMEADOW, MA 01028-1828
(413) 525-0100
(413) 525-8608
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
016684
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0272167
—
MA
Enumeration date
07/03/2007
Last updated
08/22/2020
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