Provider Demographics
NPI:1982103156
Name:BERKSHIRE DENTAL ARTS, PC
Entity Type:Organization
Organization Name:BERKSHIRE DENTAL ARTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:413-442-7213
Mailing Address - Street 1:911 N FOOTE AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-3701
Mailing Address - Country:US
Mailing Address - Phone:773-595-5858
Mailing Address - Fax:
Practice Address - Street 1:435 SOUTH ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-6892
Practice Address - Country:US
Practice Address - Phone:413-442-7213
Practice Address - Fax:413-442-7870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-02
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1856263261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental