MEDICARE: CHESTNUT HILL DENTAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry		MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	159868	OTHER	MA	DR YUKO TORIGOE
2	903950	OTHER	MA	DR ROSA CALCANO
3	584515	OTHER	MA	DR RICHARD ROSEN

General Provider Information

NPI Number	:	1104084003
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHESTNUT HILL DENTAL

Provider Business Mailing Address
First Line	:	631A VFW PKWY
Second Line	:
City	:	CHESTNUT HILL
State	:	MA
Zip	:	02467-3656
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	631A VFW PKWY
Second Line	:
City	:	CHESTNUT HILL
State	:	MA
Zip	:	02467-3656
Country	:	US
Telephone Number	:	617-327-3500
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. RICHARD A. ROSEN
Credential	:	DDS
Telephone Number	:	617-327-3500

Provider Enumeration Date	:	05/28/2008
Last Update Date	:	07/21/2022

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1679621387 — DR. RICHARD A ROSEN D.D.S.
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Practice Location Address:

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Directions to “CHESTNUT HILL DENTAL ” Practice Location

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