Organization
HATHAWAY ROAD DENTAL, PC
Active
Other names
Cortland Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE JACOMINO (DIRECTOR OF PAYOR RELATIONS)
(770) 916-5036
Entity
Organization
Contact information
Practice address
217 SOUTH STREET, HOLYOKE, MA 04010
(770) 916-9000
(770) 904-5666
Mailing address
210 INTERSTATE NORTH PKWY SE STE 300, ATLANTA, GA 30339-2233
(770) 916-9000
(770) 904-5666
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21450
MA
Other
Enumeration date
07/03/2007
Last updated
07/20/2022
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