Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DN1856609 | MA |
NPI | 1003273004 |
---|---|
Provider Name | Dr. Katherine Ann Fish |
First Address | Greenfield, MA 01301-1931 |
Second Address | Greenfield, MA 01301-1931 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2016 |
Last Update Date | 21/01/2016 |