Organization
MODESTOW FAMILY DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE KERSBERGEN (BUSINESS ADMINISTRATOR)
(413) 586-5887
Entity
Organization
Contact information
Practice address
190 NONOTUCK STREET, SUITE 101, FLORENCE, MA 01062-1934
(413) 586-5887
Mailing address
190 NONOTUCK STREET, SUITE 101, FLORENCE, MA 01062-1934
(413) 586-5887
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
20017
MA
Other
Enumeration date
03/21/2017
Last updated
03/21/2017
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