| NPI | 1124537980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNA ZIEMBA Chief Administrator 413-786-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 10524) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2022-07-21 |