MEDICARE: DR. HARRY PETER TREON D.M.D.

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	122300000X	Dentist	18445	MA

General Provider Information

NPI Number	:	1891810610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARRY PETER TREON D.M.D.

Provider Business Mailing Address
First Line	:	4452 WASHINGTON ST
Second Line	:
City	:	ROSLINDALE
State	:	MA
Zip	:	02131-3440
Country	:	US
Telephone Number	:	617-323-6020
Fax Number	:

Provider Business Practice Location Address
First Line	:	4452 WASHINGTON STREET
Second Line	:
City	:	ROSLINDALE
State	:	MA
Zip	:	02131
Country	:	US
Telephone Number	:	617-323-6020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	08/20/2020

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