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General NPI Number Information
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NPI Number | 1912149105
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Entity Type | Organization
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Legal Business Name | BARRY L SPIRO DDS PC
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Dates
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Enumeration Date | 04/02/2009
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Last Update Date | 04/02/2009
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Provider Practice Location Address
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Address Line | 670 CENTRE ST
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City | JAMAICA PLAIN
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State | MA
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Zip | 02130-2511
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Country | US
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Telephone | 617-524-7860
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Fax |
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Provider Business Mailing Address
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Address Line | 670 CENTRE ST
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City | JAMAICA PLAIN
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State | MA
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Zip | 02130-2511
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BARRY SPIRO
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Credential |
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Telephone | 617-524-7860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 16374
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License Number State | MA
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