Provider Demographics
NPI:1548776032
Name:PRECISION DENTAL ASSOCIATES OF HADLEY LLC
Entity Type:Organization
Organization Name:PRECISION DENTAL ASSOCIATES OF HADLEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PIPER
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:413-586-3306
Mailing Address - Street 1:PO BOX 345
Mailing Address - Street 2:
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-0345
Mailing Address - Country:US
Mailing Address - Phone:413-586-3306
Mailing Address - Fax:
Practice Address - Street 1:190 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-9542
Practice Address - Country:US
Practice Address - Phone:413-586-3306
Practice Address - Fax:413-586-8847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-19
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty