Provider Demographics
NPI:1285712794
Name:INSOGNA, FREDERICK JOSEPH (DMD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:JOSEPH
Last Name:INSOGNA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 HIGH STREET
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090
Mailing Address - Country:US
Mailing Address - Phone:778-132-6193
Mailing Address - Fax:781-326-6508
Practice Address - Street 1:805 HIGH STREET
Practice Address - Street 2:SUITE 202
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090
Practice Address - Country:US
Practice Address - Phone:778-132-6193
Practice Address - Fax:781-326-6508
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA148321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice