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General NPI Number Information
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NPI Number | 1164198305
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Entity Type | Organization
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Legal Business Name | ZERVAS DENTISTRY PLLC
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Dates
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Enumeration Date | 08/18/2021
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Last Update Date | 08/18/2021
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Provider Practice Location Address
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Address Line | 55 FEDERAL ST STE 240
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City | GREENFIELD
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State | MA
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Zip | 01301-2549
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Country | US
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Telephone | 413-772-0884
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Fax | 413-773-7234
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Provider Business Mailing Address
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Address Line | 55 FEDERAL ST STE 240
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City | GREENFIELD
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State | MA
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Zip | 01301-2549
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Country | US
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Telephone | 413-772-0884
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Fax | 413-773-7234
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Authorized Official
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Title or Position | MEMBER
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Name | THEODORE ZERVAS
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Credential | DMD
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Telephone | 860-834-1319
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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