Provider Demographics
NPI:1821666710
Name:NORTHAMPTON DENTAL SPECIALISTS GROUP PC
Entity Type:Organization
Organization Name:NORTHAMPTON DENTAL SPECIALISTS GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:
Authorized Official - Last Name:COTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-519-3657
Mailing Address - Street 1:243 KING ST STE 112
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2328
Mailing Address - Country:US
Mailing Address - Phone:413-584-5199
Mailing Address - Fax:
Practice Address - Street 1:243 KING ST STE 112
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2328
Practice Address - Country:US
Practice Address - Phone:413-584-5199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty