MEDICARE: DR. MARILYN FRANCES MCDEVITT DDS

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	15746	MA

General Provider Information

NPI Number	:	1962567446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARILYN FRANCES MCDEVITT DDS

Provider Business Mailing Address
First Line	:	236 HIGH ST
Second Line	:
City	:	CANTON
State	:	MA
Zip	:	02021-3654
Country	:	US
Telephone Number	:	781-828-5742
Fax Number	:

Provider Business Practice Location Address
First Line	:	780 BOYLSTON ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02199-7820
Country	:	US
Telephone Number	:	617-424-7138
Fax Number	:

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

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	07/08/2007

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