Organization
BERKSHIRE FACIAL SURGERY INC
Active
Parent organization
BERKSHIRE FACIAL SURGERY INC
Other names
Berkshire Facial Surgery Inc
Organization subpart
Yes
Provider details
NPI number
Legal business name
BERKSHIRE FACIAL SURGERY INC
Authorized official
DR. STEPHEN JOSEPH PAOLELLA DMD MD (PRESIDENT)
(413) 562-1100
Entity
Organization
Contact information
Practice address
53 SOUTHAMPTON ROAD, SUITE 5, WESTFIELD, MA 01085-1382
(413) 562-1100
(413) 562-3653
Mailing address
53 SOUTHAMPTON ROAD, SUITE 5, WESTFIELD, MA 01085-1382
(413) 562-1100
(413) 562-3653
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X08683
BCBS
MA
Enumeration date
10/01/2007
Last updated
10/01/2007
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