| NPI | 1003216763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERIC PHILIP HYMAN Owner 413-528-4680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA 15898) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2014-09-01 |
| Last Update Date | 2014-09-01 |