Individual
DAVID JOHN VANDERBOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1146 MEMORIAL DR, CHICOPEE, MA 01020-3960
(413) 593-8904
(413) 593-5366
Mailing address
46 REPUBLIC DR, BLOOMFIELD, CT 06002-5455
(617) 471-0223
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21684
MA
Other
Enumeration date
03/09/2007
Last updated
07/08/2007
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