Healthcare Provider Details

I. General information

NPI: 1366610073
Provider Name (Legal Business Name): DONALD H. MEAD, D.D.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2008
Last Update Date: 02/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 ASHLAND ST
NORTH ADAMS MA
01247-4513
US

IV. Provider business mailing address

176 ASHLAND ST
NORTH ADAMS MA
01247-4513
US

V. Phone/Fax

Practice location:
  • Phone: 413-663-3378
  • Fax: 413-663-3459
Mailing address:
  • Phone: 413-663-3378
  • Fax: 413-663-3459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14002
License Number StateMA

VIII. Authorized Official

Name: MRS. AUDREY R MORIN
Title or Position: OFFICE MANAGER
Credential:
Phone: 413-663-3378