Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 19611 | MA |
NPI | 1114958444 |
---|---|
Provider Name | Dr. William John Bontempi |
First Address | Westfield, MA 01085-1582 |
Second Address | Westfield, MA 01085-1582 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H85984 | (02) |