| NPI | 1083902266 |
|---|---|
| Doing Business As | MODESTOW FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MICHELLE KERSBERGEN Office Manager 413-586-5887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN20017) |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2011-07-21 |