Organization
BOULDER BROOK DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY A CHASE D.M.D (MBR/OWNER)
(413) 547-8085
Entity
Organization
Contact information
Practice address
104 DOWD CT, LUDLOW, MA 01056-1743
(413) 547-8085
(413) 547-8085
Mailing address
104 DOWD CT, LUDLOW, MA 01056-1743
(413) 547-8085
(413) 547-8085
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17956
MA
Other
Enumeration date
06/05/2006
Last updated
08/22/2020
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