Organization
BAYSTATE DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW J HALUCH DDS (COO)
(413) 733-5700
Entity
Organization
Contact information
Practice address
516 MONTGOMERY ST, CHICOPEE, MA 01020-1469
(413) 534-5144
Mailing address
1795 MAIN ST, SUITE 212, SPRINGFIELD, MA 01103-1077
(413) 733-5700
(413) 439-0563
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN20704
MA
Other
Enumeration date
05/08/2012
Last updated
05/08/2012
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