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General NPI Number Information
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NPI Number | 1871638486
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Entity Type | Organization
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Legal Business Name | DR. WILLIAM C. O'DONNELL DMD
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 262 SOUTH ST
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City | PITTSFIELD
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State | MA
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Zip | 01201-6811
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Country | US
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Telephone | 413-443-0703
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Fax | 413-443-0746
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Provider Business Mailing Address
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Address Line | 160 FAIRVIEW AVE FAIRVIEW PLAZA
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City | HUDSON
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State | NY
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Zip | 12534-1267
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Country | US
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Telephone | 518-828-1316
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Fax | 413-443-0746
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Authorized Official
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Title or Position | RECEPTIONIST
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Name | MRS. THERESA L. JEROME
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Credential |
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Telephone | 413-443-0703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 033194-1
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License Number State | NY
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