Individual
DR. KELLY ANN SCANLON-CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
2377 BOSTON RD, SUITE 103, WILBRAHAM, MA 01095-1254
(413) 596-6444
(413) 596-6237
Mailing address
2377 BOSTON RD, SUITE 103, WILBRAHAM, MA 01095-1254
(413) 596-6444
(413) 596-6237
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17956
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053350470
NPI-BOULDER BROOK DENTAL
MA
Enumeration date
04/12/2007
Last updated
07/08/2007
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