| Boulder Brook Dental, LLC | |
|
104 Dowd Ct Ludlow MA 01056-1743 | |
| (413) 547-8085 | |
| (413) 547-8085 |
| Full Name | Boulder Brook Dental, LLC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 104 Dowd Ct, Ludlow, Massachusetts |
| Authorized Official Name and Position | Kelly a Chase (MBR/OWNER) |
| Authorized Official Contact | 4135478085 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boulder Brook Dental, LLC 104 Dowd Ct Ludlow MA 01056-1743 Ph: (413) 547-8085 | Boulder Brook Dental, LLC 104 Dowd Ct Ludlow MA 01056-1743 Ph: (413) 547-8085 |
| NPI Number | 1053350470 |
|---|---|
| Provider Enumeration Date | 06/05/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053350470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 17956 (Massachusetts) | Primary |
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