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General NPI Number Information
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NPI Number | 1518131101
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Entity Type | Organization
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Legal Business Name | JANIENE GRESLA, D.D.S.,P.C.
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Dates
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Enumeration Date | 04/15/2008
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 120 CAMBRIDGE ST
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City | BURLINGTON
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State | MA
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Zip | 01803-4135
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Country | US
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Telephone | 781-273-0225
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Fax | 781-273-5632
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Provider Business Mailing Address
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Address Line | 120 CAMBRIDGE ST
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City | BURLINGTON
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State | MA
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Zip | 01803-4135
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Country | US
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Telephone | 781-273-0225
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Fax | 781-273-5632
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Authorized Official
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Title or Position | DENTIST AND OWNER
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Name | DR. JANIENE FRANCES GRESLA
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Credential | D.D.S.
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Telephone | 781-273-0225
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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 | 19634
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License Number State | MA
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