Individual
DR. WILLIAM CHARLES ODONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD PC
Contact information
Practice address
262 SOUTH ST, PITTSFIELD, MA 01201
(413) 443-0703
(413) 443-0746
Mailing address
12 SOUTHBROOK LANE, PITTSFIELD, MA 01201
(413) 443-1793
(413) 443-0746
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
0331941
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
13078
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0250953
—
MA
01
—
X11995
BLUE CROSS BLUE SHIELD
MA
Enumeration date
10/28/2006
Last updated
07/08/2007
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