Back Bay Dental Group Llc

NPI 1063758639 - Dentist - 122300000X

NPI Details
NPI 1063758639
Enumeration Date 12/29/2012
Last Updated 01/03/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name RICHARD RICHARD
Position PRESIDENT
Phone (617) 247-9966
Fax
Practice Location
21 BAY STATE RD
BOSTON MA, 02215-2101, US
Phone (617) 247-9966
Fax
Business Location
21 BAY STATE RD
BOSTON MA, 02215-2101, US
Phone
Fax
Toxanomy
Taxonomy Code 122300000X
License State
License Number
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According to our database, Back Bay Dental Group Llc NPI is 1063758639, taxonomy code is 122300000X Back Bay Dental Group Llc physically located at 21 Bay State Rd, Boston MA, 02215-2101. NPI Number 1033115704 has the healthcare provider type.

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1063758639 NPI number is provided on an as is basis without warranty of any kind. 1063758639 is maintained by the National Plan & Provider Enumeration System. The contents of Back Bay Dental Group Llc are for informational purposes only.