Organization
DR. WILLIAM C. O'DONNELL DMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESA L. JEROME (RECEPTIONIST)
(413) 443-0703
Entity
Organization
Contact information
Practice address
262 SOUTH ST, PITTSFIELD, MA 01201-6811
(413) 443-0703
(413) 443-0746
Mailing address
160 FAIRVIEW AVE, FAIRVIEW PLAZA, HUDSON, NY 12534-1267
(518) 828-1316
(413) 443-0746
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
033194-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0250953
MASSHEALTH
MA
01
—
159991
UNITED CONCORDIA
NY
01
—
X11995
BC BS OF MASS
MA
Enumeration date
02/21/2007
Last updated
08/22/2020
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