Healthcare Provider Details

I. General information

NPI: 1497669816
Provider Name (Legal Business Name): HENRY A VASQUEZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 NORTH ST
PITTSFIELD MA
01201-5493
US

IV. Provider business mailing address

510 NORTH ST
PITTSFIELD MA
01201-5493
US

V. Phone/Fax

Practice location:
  • Phone: 413-447-7281
  • Fax: 413-395-7922
Mailing address:
  • Phone: 413-447-7281
  • Fax: 413-395-7922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDL101857
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: