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295 Devonshire St Ste 301 Boston MA 02110-1266 | |
| (617) 418-6940 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 295 Devonshire St Ste 301, Boston, Massachusetts |
| Authorized Official Name and Position | Rishi Shukla (AUTHORIZED ADMINISTRATOR) |
| Authorized Official Contact | 6174186940 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
198 Tremont St Ste 436 Boston MA 02116-4705 Ph: () - | 295 Devonshire St Ste 301 Boston MA 02110-1266 Ph: (617) 418-6940 |
| NPI Number | 1386258531 |
|---|---|
| Provider Enumeration Date | 09/04/2020 |
| Last Update Date | 03/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386258531 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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