=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518829704
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MONTSHIRE WEST SPRINGFIELD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/26/2025
-----------------------------------------------------
Last Update Date | 11/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 46 DAGGETT DR
-----------------------------------------------------
City | WEST SPRINGFIELD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01089-4638
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-737-6906
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 46 DAGGETT DR
-----------------------------------------------------
City | WEST SPRINGFIELD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01089-4638
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-737-6906
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | COLIN BOSWELL
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 641-780-7792
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0221X
-----------------------------------------------------
Taxonomy Name | Pediatric Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------