Individual
TANYA SABRINA CALLE MORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
505 FRONT ST, CHICOPEE, MA 01013-3140
(413) 420-2222
Mailing address
33 HILLCREST PARK APT A, SOUTH HADLEY, MA 01075-2976
(407) 415-8583
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN10000132
MA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/06/2023
Last updated
05/23/2024
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