Individual
DR. DAVID EDWARD WATERFALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1084 MAIN STREET, HOLDEN, MA 01520-1286
(508) 829-4575
(508) 829-9805
Mailing address
1084 MAIN STREET, HOLDEN, MA 01520-1286
(508) 829-4575
(508) 829-9805
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13193
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000-149
DELTA DENTAL
MA
01
—
190636
UNITED CONCORDIA
—
01
—
X08096
BLUE CROSS/BLUE SHIELD
MA
Enumeration date
10/03/2006
Last updated
07/08/2007
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