Organization
DR. MARK S. LEVY, DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARON N LEVY (CLERK)
(413) 567-6528
Entity
Organization
Contact information
Practice address
1795 MAIN ST, SUITE 203, SPRINGFIELD, MA 01103-1077
(413) 732-4916
Mailing address
1795 MAIN ST, SUITE 203, SPRINGFIELD, MA 01103-1077
(413) 732-4916
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12315
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0246034
—
MA
01
—
X03981
BLUE CROSS BLUE SHIELD MA
MA
Enumeration date
03/06/2007
Last updated
08/22/2020
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