| NPI | 1053842245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE KERSBERGEN Business Administrator 413-586-5887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA 20017) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2017-03-21 |