Healthcare Provider Details

I. General information

NPI: 1407282999
Provider Name (Legal Business Name): RAMIPAL S KHURANA BDS, DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2013
Last Update Date: 09/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E NEWTON ST # G202
BOSTON MA
02118-2308
US

IV. Provider business mailing address

580 COMMONWEALTH AVE UNIT 902
BOSTON MA
02215-2526
US

V. Phone/Fax

Practice location:
  • Phone: 617-638-4750
  • Fax:
Mailing address:
  • Phone: 617-838-0710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDL12064
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: