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General NPI Number Information
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NPI Number | 1003709734
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Entity Type | Organization
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Legal Business Name | MEADOWLAND DENTAL PLLC
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 124 SHAKER RD STE B
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City | EAST LONGMEADOW
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State | MA
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Zip | 01028-2759
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Country | US
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Telephone | 413-500-8010
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Fax | 413-600-8010
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Provider Business Mailing Address
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Address Line | 12 HIGHLAND AVE
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City | ELLINGTON
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State | CT
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Zip | 06029-3794
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Country | US
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Telephone | 201-850-3567
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | MAYANK BHARATKUMAR CHALIAWALA
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Credential | DDS
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Telephone | 201-850-3567
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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