Provider Demographics
NPI:1932560869
Name:ARCHAMBAULT & ARCHAMBAULT, PLLC
Entity Type:Organization
Organization Name:ARCHAMBAULT & ARCHAMBAULT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:COLE
Authorized Official - Middle Name:G
Authorized Official - Last Name:ARCHAMBAULT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:413-737-6387
Mailing Address - Street 1:1284 ELM ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-1827
Mailing Address - Country:US
Mailing Address - Phone:413-737-6387
Mailing Address - Fax:413-746-4151
Practice Address - Street 1:1284 ELM ST
Practice Address - Street 2:SUITE 1
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-1827
Practice Address - Country:US
Practice Address - Phone:413-737-6387
Practice Address - Fax:413-746-4151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-21
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1856538122300000X
MADN14342122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1699187427OtherPERSONAL
MA1407860869OtherPERSONAL
MA1699187427OtherPERSONAL