| NPI | 1184735326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN F WALDER Doctor 413-586-8455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 15615) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 19003) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2008-12-11 |