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General NPI Number Information
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NPI Number | 1568302008
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Entity Type | Organization
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Legal Business Name | BERKSHIRE PROSTHETIC AND RESTORATIVE DENTISTRY
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Dates
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Enumeration Date | 04/01/2026
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Last Update Date | 04/01/2026
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Provider Practice Location Address
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Address Line | 114 WENDELL AVE APT 1
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City | PITTSFIELD
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State | MA
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Zip | 01201-6975
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Country | US
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Telephone | 413-442-8684
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Fax |
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Provider Business Mailing Address
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Address Line | 114 WENDELL AVE APT 1
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City | PITTSFIELD
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State | MA
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Zip | 01201-6975
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Country | US
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Telephone | 413-442-8684
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Fax |
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Authorized Official
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Title or Position | ACCESS MANAGER
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Name | MICHELLE DICKINSON
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Credential |
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Telephone | 413-884-4383
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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 |
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License Number State |
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