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NPI Code Detail

MEDICARE: LAURA GRAMSE DMD PC

MEDICARE: LAURA GRAMSE DMD PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry18803MA

General Provider Information

NPI Number : 1558693630
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAURA GRAMSE DMD PC
Provider Business Mailing Address
First Line : 2194 WILBRAHAM RD
Second Line :
City : SPRINGFIELD
State : MA
Zip : 01129-1810
Country : US
Telephone Number : 413-783-6907
Fax Number : 413-783-0362
Provider Business Practice Location Address
First Line : 2194 WILBRAHAM RD
Second Line :
City : SPRINGFIELD
State : MA
Zip : 01129-1810
Country : US
Telephone Number : 413-783-6907
Fax Number : 413-783-0362
Authorized Official
Title or Position : OWNER
Name : DR. LAURA GRAMSE
Credential : DMD
Telephone Number : 413-783-6907
Provider Enumeration Date : 02/01/2010
Last Update Date : 02/01/2010

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Directions to “LAURA GRAMSE DMD PC ” Practice Location

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