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General NPI Number Information
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NPI Number | 1245716620
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Entity Type | Organization
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Legal Business Name | IVETA IONTCHEVA-BAREHMI DMD, PC
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Dates
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Enumeration Date | 07/18/2018
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Last Update Date | 07/18/2018
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Provider Practice Location Address
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Address Line | 1842 BEACON ST STE 305
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City | BROOKLINE
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State | MA
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Zip | 02445-1922
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Country | US
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Telephone | 617-868-1516
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Fax |
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Provider Business Mailing Address
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Address Line | 1842 BEACON ST STE 305
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City | BROOKLINE
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State | MA
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Zip | 02445-1922
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Country | US
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Telephone | 617-868-1516
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. IVETA IONTCHEVA-BAREHMI
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Credential | DMD, MS, DSC,
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Telephone | 617-868-1516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 20930
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License Number State | MA
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