| Church Street Dental, Pc | |
|
109 Church St Ste 1 Chicopee MA 01020-1814 | |
| (214) 336-9767 | |
| Not Available |
| Full Name | Church Street Dental, Pc |
|---|---|
| Speciality | Dentist |
| Location | 109 Church St Ste 1, Chicopee, Massachusetts |
| Authorized Official Name and Position | Ranganayaki Chirumamilla (PRESIDENT) |
| Authorized Official Contact | 2143369767 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Church Street Dental, Pc 109 Church St Ste 1 Chicopee MA 01020-1814 Ph: (214) 336-9767 | Church Street Dental, Pc 109 Church St Ste 1 Chicopee MA 01020-1814 Ph: (214) 336-9767 |
| NPI Number | 1720405632 |
|---|---|
| Provider Enumeration Date | 03/28/2014 |
| Last Update Date | 03/28/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720405632 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 21848 (Massachusetts) | Primary |
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