Provider Demographics
NPI:1871723106
Name:PRINCEWILL, OBIOMA ANULI (DMD)
Entity type:Individual
Prefix:DR
First Name:OBIOMA
Middle Name:ANULI
Last Name:PRINCEWILL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:OBIOMA
Other - Middle Name:ANULI
Other - Last Name:OKAFOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1795 MAIN ST.
Mailing Address - Street 2:SUITE 116
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01103
Mailing Address - Country:US
Mailing Address - Phone:413-733-6651
Mailing Address - Fax:
Practice Address - Street 1:1795 MAIN ST
Practice Address - Street 2:SUITE 116
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103
Practice Address - Country:US
Practice Address - Phone:413-733-6651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18551851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice