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Individual

KATHLEEN TAKACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD, MPH

Contact information

Practice address
326 NICHOLS RD, FITCHBURG, MA 01420-1914
(978) 878-8100
Mailing address
20 MORGAN DR UNIT 35, LEBANON, NH 03766-1484
(207) 253-9434

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DEN.00205494
CO
122300000X
Dentist
Primary
DN1858901
MA
1223G0001X
General Practice Dentistry
04407
NH

Other

Enumeration date
06/01/2018
Last updated
04/05/2023
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