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General NPI Number Information
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NPI Number | 1518081389
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Entity Type | Individual
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Provider Name | BERDJ KILADJIAN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1842 BEACON ST
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City | BROOKLINE
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State | MA
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Zip | 02445-1930
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Country | US
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Telephone | 617-566-5445
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Fax | 617-730-8482
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Provider Business Mailing Address
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Address Line | 1842 BEACON ST
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City | BROOKLINE
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State | MA
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Zip | 02445-1930
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Country | US
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Telephone | 617-566-5445
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Fax | 617-730-8482
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 17049
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License Number State | MA
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