The Loose Tooth
NPI #1750689576 in Chicopee, Massachusetts
Provider Information
- NPI Number
- 1750689576
- Entity Type
- Organization
- Organization Name
- The Loose Tooth
- Primary Specialty
- Health Maintenance Organization
- Enumeration Date
- Mar 2, 2011
- Last Updated
- Mar 2, 2011
Practice Location
- Address
- 874 PROSPECT ST
- City
- Chicopee
- State
- Massachusetts
- ZIP Code
- 01020-3107
- Phone
- (413) 888-6767
Authorized Official
- Name
- MRS. JENNIFER HAUSCHILD, RDH, PHDH
- Title
- OWNER, OPPERATOR
- Phone
- 14138886767
Specialties & Taxonomy Codes
| Specialty |
|---|
| Health Maintenance Organization |
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