Healthcare Provider Details

I. General information

NPI: 1518117837
Provider Name (Legal Business Name): KASIA SZARY DDS, P.C. INS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2008
Last Update Date: 09/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128A TREMONT ST
BOSTON MA
02108-4716
US

IV. Provider business mailing address

128A TREMONT ST
BOSTON MA
02108-4716
US

V. Phone/Fax

Practice location:
  • Phone: 617-426-8029
  • Fax:
Mailing address:
  • Phone: 617-426-8029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number21422
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number21422
License Number StateMA

VIII. Authorized Official

Name: DR. KASIA SZARY
Title or Position: OWNER
Credential: DDS
Phone: 617-426-8029