| Aesthetic Smile Reconstruction Pc | |
|
75 3rd Ave Ste 1b Waltham MA 02451-7549 | |
| (781) 487-1111 | |
| Not Available |
| Full Name | Aesthetic Smile Reconstruction Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 75 3rd Ave Ste 1b, Waltham, Massachusetts |
| Authorized Official Name and Position | Charles Sutera (PRESIDENT) |
| Authorized Official Contact | 9783148974 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aesthetic Smile Reconstruction Pc 20 Roosevelt Rd Medford MA 02155-2519 Ph: (978) 314-8974 | Aesthetic Smile Reconstruction Pc 75 3rd Ave Ste 1b Waltham MA 02451-7549 Ph: (781) 487-1111 |
| NPI Number | 1437621224 |
|---|---|
| Provider Enumeration Date | 12/18/2018 |
| Last Update Date | 12/18/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437621224 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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