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General NPI Number Information
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NPI Number | 1255748919
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Entity Type | Organization
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Legal Business Name | PLEASANT DENTAL LLC
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Dates
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Enumeration Date | 07/15/2014
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Last Update Date | 07/15/2014
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Provider Practice Location Address
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Address Line | 1318 BEACON ST STE 20
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City | BROOKLINE
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State | MA
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Zip | 02446-3744
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Country | US
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Telephone | 617-975-3399
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Fax |
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Provider Business Mailing Address
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Address Line | 1318 BEACON ST STE 20
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City | BROOKLINE
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State | MA
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Zip | 02446-3744
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Country | US
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Telephone |
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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. YEN CHING CHEN
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Credential |
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Telephone | 617-975-3399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 17391
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License Number State | MA
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