Organization
BAYSTATE DENTAL PRACTICE, LLC
Active
Other names
Baystate Dental PC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANN MARIE SANTOS (PRACTICE MANAGER)
(413) 439-0566
Entity
Organization
Contact information
Practice address
1795 MAIN ST, SUITE 215, SPRINGFIELD, MA 01103-1077
(413) 733-6651
(413) 733-6653
Mailing address
1795 MAIN ST, SUITE 116, SPRINGFIELD, MA 01103-1077
(413) 439-0566
(413) 439-0563
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN15623
MA
Other
Enumeration date
01/03/2014
Last updated
01/13/2014
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