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General NPI Number Information
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NPI Number | 1194103499
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Entity Type | Organization
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Legal Business Name | PIONEER VALLEY PEDIATRIC DENTISTRY
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Dates
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Enumeration Date | 05/07/2015
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Last Update Date | 05/07/2015
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Provider Practice Location Address
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Address Line | 51 CHURCH ST
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City | GREENFIELD
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State | MA
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Zip | 01301-2951
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Country | US
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Telephone | 413-774-2369
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Fax |
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Provider Business Mailing Address
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Address Line | 51 CHURCH ST
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City | GREENFIELD
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State | MA
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Zip | 01301-2951
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Country | US
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Telephone | 413-774-2369
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ASHISH PARAMESWARAN
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Credential | DMD
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Telephone | 413-774-2369
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN1856226
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License Number State | MA
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