Organization Name: | MONTAGUE DENTAL ARTS |
NPI Number: | 1548646482 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GEETU SHOKEEN (GENERAL DENTIST) |
Mailing Address: | 300 Avenue A Turners Falls |
State: | MA US |
Postal Code: | 013761831 |
Phone Number: | 8609904377 |
Fax Number: | |
NPI Enumeration Date: | 08/03/2015 |
NPI Last Update Date: | 08/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | DN1855684 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |