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General NPI Number Information
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NPI Number | 1720392194
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Entity Type | Individual
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Provider Name | DIETER HERBERT KNAUSS D.M.D
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Gender | Male
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Dates
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Enumeration Date | 07/28/2010
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Last Update Date | 07/28/2010
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Provider Practice Location Address
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Address Line | 1852 CENTRE ST
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City | WEST ROXBURY
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State | MA
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Zip | 02132-1901
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Country | US
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Telephone | 617-325-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 260 PLEASANT STREET
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City | EPPING
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State | NH
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Zip | 03042
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Country | US
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Telephone | 603-520-5383
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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 | DN1855490
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License Number State | MA
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