Individual
SANDER JOSHUA FASTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
12 CENTER STREET, NORTHAMPTON, MA 01061
(413) 586-4510
Mailing address
PO BOX 1027, 12 CENTER STREET, NORTHAMPTON, MA 01061
(413) 586-4510
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11390
MA
Other
Enumeration date
09/14/2006
Last updated
07/08/2007
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