Individual
SUSAN C FIORILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
GENERAL DENTISTRY
Contact information
Practice address
10 WINTHROP ST, VERNON MEDICAL CENTER 1, WORCESTER, MA 01604-4435
(508) 756-0990
(508) 757-2687
Mailing address
10 WINTHROP ST, VERNON MEDICAL CENTER 1, WORCESTER, MA 01604-4435
(508) 756-0990
(508) 757-2687
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14547
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1300709
CMSP-GROUP
MA
05
—
1300709
—
MA
01
—
14547
ALTUS DENTAL
MA
01
—
14547
DELTA DENTAL
WI
01
—
Y10141
BCBS DENTAL-GROUP
MA
Enumeration date
08/11/2006
Last updated
12/08/2008
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