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General NPI Number Information
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NPI Number | 1285837161
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Entity Type | Individual
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Provider Name | ALICE Y. LWIN D.M.D
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Gender | Female
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 279 BROADWAY
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City | CHELSEA
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State | MA
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Zip | 02150-2807
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Country | US
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Telephone | 617-884-0165
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Fax | 617-884-0187
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Provider Business Mailing Address
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Address Line | 5 HALLEN AVE
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City | MILTON
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State | MA
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Zip | 02186-4401
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Country | US
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Telephone | 617-416-9081
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Fax | 617-265-9333
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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 | 20130
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License Number State | MA
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