| NPI | 1942649058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN ELCOX Human Resource Manager 413-445-6680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 122300000X Dentist | |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2015-02-23 |