| NPI | 1942925896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK JOSEPH KOSTEK CFO 413-693-1022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 251S00000X |
| 261QD0000X Clinic/Center, Dental | |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2022-10-04 |