Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 19646 | MA |
N | 122300000X | Dentist | 2126 | VT |
N | 122300000X | Dentist | 3688 | ME |
N | 122300000X | Dentist | 8692 | CT |
NPI | 1003993668 |
---|---|
Provider Name | Dr. Anita Chopra |
First Address | Worcester, MA 01604 |
Second Address | Wilbraham, MA 01095 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |