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General NPI Number Information
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NPI Number | 1871781849
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Entity Type | Individual
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Provider Name | KENNETH ALBERT MALAMENT D.D.S.,M.SC.D.
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Gender | Male
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Dates
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Enumeration Date | 10/04/2007
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Last Update Date | 10/04/2007
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Provider Practice Location Address
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Address Line | 50 STANIFORD ST 5TH FLOOR
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City | BOSTON
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State | MA
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Zip | 02114-2517
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Country | US
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Telephone | 617-523-5451
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Fax | 617-367-9145
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Provider Business Mailing Address
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Address Line | 50 STANIFORD ST 5TH FLOOR
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City | BOSTON
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State | MA
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Zip | 02114-2517
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Country | US
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Telephone | 617-523-5451
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Fax | 617-367-9145
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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 | 12823
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License Number State | MA
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