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General NPI Number Information
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NPI Number | 1861371239
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Entity Type | Organization
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Legal Business Name | WESTERN MASS DENTAL SPECIALTY SPRINGFIELD PC
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Dates
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Enumeration Date | 08/29/2025
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 269 LOCUST ST UNIT F1
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City | NORTHAMPTON
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State | MA
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Zip | 01062-2003
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Country | US
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Telephone | 413-341-9844
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Fax |
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Provider Business Mailing Address
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Address Line | 269 LOCUST ST UNIT F1
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City | NORTHAMPTON
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State | MA
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Zip | 01062-2003
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Country | US
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Telephone | 413-341-9844
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Fax |
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Authorized Official
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Title or Position | CREDENTIALS MANAGER
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Name | CHRISTINE BRANIGAN
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Credential |
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Telephone | 631-696-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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