Memorial Drive Dental Associates PC
NPI #1811083355 in Chicopee, Massachusetts
Provider Information
- NPI Number
- 1811083355
- Entity Type
- Organization
- Organization Name
- Memorial Drive Dental Associates PC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Oct 4, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 1176 MEMORIAL DRIVE
- City
- Chicopee
- State
- Massachusetts
- ZIP Code
- 01020-3960
- Phone
- (413) 593-5772
Authorized Official
- Name
- DR. TIMOTHY J RUSIECKI, DDS
- Title
- PRESIDENT
- Phone
- (413) 593-5772
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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