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General NPI Number Information
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NPI Number | 1558620997
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Entity Type | Organization
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Legal Business Name | RILEY & HAN DENTAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 05/04/2012
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Last Update Date | 06/01/2022
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Provider Practice Location Address
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Address Line | 10 HAWTHORNE PL SUITE 102
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City | BOSTON
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State | MA
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Zip | 02114-2336
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Country | US
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Telephone | 617-723-4032
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Fax | 617-723-4059
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Provider Business Mailing Address
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Address Line | 10 HAWTHORNE PL SUITE 102
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City | BOSTON
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State | MA
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Zip | 02114-2336
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Country | US
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Telephone | 617-723-4032
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Fax | 617-723-4059
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | NANCY A. KING-BURKE
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Credential |
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Telephone | 617-723-4032
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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 | DN12185
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DN19965
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License Number State | MA
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