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General NPI Number Information
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NPI Number | 1205436276
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Entity Type | Organization
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Legal Business Name | THE NURTURE FRENECTOMY CENTER
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Dates
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Enumeration Date | 10/29/2020
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Last Update Date | 10/29/2020
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Provider Practice Location Address
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Address Line | 200 ELM ST STE 1
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City | PITTSFIELD
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State | MA
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Zip | 01201-6551
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Country | US
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Telephone | 413-329-3292
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Fax |
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Provider Business Mailing Address
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Address Line | 193 OSCEOLA RD
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City | RICHMOND
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State | MA
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Zip | 01254-5211
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Country | US
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Telephone | 443-610-7590
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAUREN BALLINGER
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Credential | DDS
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Telephone | 413-329-3292
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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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