Church Street Dental, PC

NPI #1720405632 in Chicopee, Massachusetts

Provider Information

NPI Number: 1720405632
Entity Type: Organization
Organization Name: Church Street Dental, PC
Primary Specialty: Dentist
Enumeration Date: Mar 28, 2014
Last Updated: Mar 28, 2014

Practice Location

Address: 109 CHURCH ST STE 1
City: Chicopee
State: Massachusetts
ZIP Code: 01020-1814
Phone: (214) 336-9767

Authorized Official

Name: RANGANAYAKI CHIRUMAMILLA
Title: PRESIDENT
Phone: (214) 336-9767

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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