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General NPI Number Information
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NPI Number | 1215942800
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Entity Type | Individual
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Provider Name | ARISTOMENIS KATSARAS DMD
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Gender | Male
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 55 BELGRADE AVE DENTAL HEALTH WORKS
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City | ROSLINDALE
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State | MA
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Zip | 02131
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Country | US
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Telephone | 617-327-4700
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Fax | 617-327-0010
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Provider Business Mailing Address
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Address Line | 77 TEMPLE STREET
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City | WEST ROXBURY
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State | MA
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Zip | 02132
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Country | US
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Telephone | 617-323-6757
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Fax | 617-327-0010
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 19362
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License Number State | MA
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