Jonathan C Sudol, DDS

Maxillofacial Surgery

West Springfield, MA 01089

Male - 24 Yrs Experience - English

Location

75 Van Deene Ave
Suite 201

West Springfield, MA 01089

Phone number

(413) 788-9621

Summary

Jonathan C Sudol, DDS is a Maxillofacial Surgery located at West Springfield, MA 01089 and is affiliated with Mercy Medical Ctr Hospitals. He received his medical degree from Other and has been in practice for more than 24 years.

Professional Identification

  1. NPI#: 1033222583
  2. PAC ID: 2365453818
  3. Clinician Enrollment ID: I20060511000274
  4. Gender: Male
  5. Enumeration: August 17 2006
  6. Last Updated: March 6 2020

Medical Credentials

  1. Credential: DDS
  2. Medical school: Other
  3. Graduation year: 1998
  4. Taxonomy: 1223S0112X
  5. Specialty: Maxillofacial Surgery
  6. All specialties: Maxillofacial Surgery

Medical Practice

  1. Organization: Mcnally Brothers
  2. Group PAC ID: 9234233966
  3. Number of Group Members: 4
  4. Medicare CCN: 220066
  5. Hospital affiliation: Mercy Medical Ctr

Medicare Assignment

  1. Clinician accepts Medicare Assignment: Y
  2. Group accepts Medicare Assignment: Y

Locations

  1. 75 Van Deene Ave, West Springfield MA 01089 (413) 788-9621
  2. 74 Court St, Westfield MA 01085 (413) 562-9687

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