Provider Demographics
NPI:1376127258
Name:REFRESH VALLEY DENTAL, PLLC
Entity Type:Organization
Organization Name:REFRESH VALLEY DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AURORA
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:646-246-3336
Mailing Address - Street 1:15 ATWOOD DR STE 203
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-4276
Mailing Address - Country:US
Mailing Address - Phone:413-387-4585
Mailing Address - Fax:
Practice Address - Street 1:15 ATWOOD DR STE 203
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-4276
Practice Address - Country:US
Practice Address - Phone:646-246-3336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-07
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty