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General NPI Number Information
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NPI Number | 1306805932
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Entity Type | Organization
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Legal Business Name | HOLYOKE DENTAL ASSOCIATES, INC.
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 09/15/2008
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Provider Practice Location Address
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Address Line | 610 SOUTH ST
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City | HOLYOKE
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State | MA
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Zip | 01040-3638
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Country | US
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Telephone | 413-533-8378
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Fax | 413-534-3989
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Provider Business Mailing Address
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Address Line | 610 SOUTH ST
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City | HOLYOKE
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State | MA
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Zip | 01040-3638
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Country | US
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Telephone | 413-533-8378
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Fax | 413-534-3989
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Authorized Official
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Title or Position | SECRETARY-TREASURER
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Name | DR. ROBERT J LIPTAK
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Credential | D.M.D.
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Telephone | 413-533-8378
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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 | 10340
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License Number State | MA
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