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General NPI Number Information
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NPI Number | 1578206090
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Entity Type | Individual
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Provider Name | EIRINI BOUTIOU
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Gender | Female
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Dates
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Enumeration Date | 04/14/2022
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | 300 CROWN COLONY DR STE 203
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City | QUINCY
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State | MA
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Zip | 02169-0929
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Country | US
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Telephone | 617-472-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 99 KNEELAND ST APT 1306
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City | BOSTON
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State | MA
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Zip | 02111-2444
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Country | US
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Telephone | 615-788-8443
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN10001190
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License Number State | MA
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