Healthcare Provider Details

I. General information

NPI: 1154422079
Provider Name (Legal Business Name): WACLAW ANTHONY HOJNOSKI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

377 MONTGOMERY STREET
CHICOPEE MA
01020-1929
US

IV. Provider business mailing address

377 MONTGOMERY STREET
CHICOPEE MA
01020-1929
US

V. Phone/Fax

Practice location:
  • Phone: 413-592-2500
  • Fax: 413-594-5010
Mailing address:
  • Phone: 413-592-2500
  • Fax: 413-594-5010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number16934
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: