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General NPI Number Information
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NPI Number | 1376811034
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Entity Type | Organization
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Legal Business Name | DR.DENTAL OF BOSTON, P.C.
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Dates
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Enumeration Date | 12/09/2011
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Last Update Date | 12/09/2011
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Provider Practice Location Address
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Address Line | 32 TREMONT ST
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City | BOSTON
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State | MA
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Zip | 02108-3201
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Country | US
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Telephone | 781-420-9920
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Fax | 978-372-1988
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Provider Business Mailing Address
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Address Line | 32 TREMONT ST
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City | BOSTON
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State | MA
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Zip | 02108-3201
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Country | US
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Telephone | 781-420-9920
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Fax | 978-372-1988
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Authorized Official
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Title or Position | MANAGER
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Name | RENEE P MCKAIN
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Credential |
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Telephone | 781-420-9920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State | MA
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