| Baystate Dental Pc | |
|
1795 Main St Springfield MA 01103-1077 | |
| (413) 733-6651 | |
| Not Available |
| Full Name | Baystate Dental Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1795 Main St, Springfield, Massachusetts |
| Authorized Official Name and Position | Ann Marie Santos (OFFICE MANAGER) |
| Authorized Official Contact | 4137336651 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Baystate Dental Pc 1795 Main St Springfield MA 01103-1077 Ph: (413) 733-6651 | Baystate Dental Pc 1795 Main St Springfield MA 01103-1077 Ph: (413) 733-6651 |
| NPI Number | 1194932368 |
|---|---|
| Provider Enumeration Date | 05/17/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194932368 | NPI | - | NPPES |
| 9730460 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 15623 (Massachusetts) | Primary |
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