| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 75 Francis St, Boston, Massachusetts |
| Authorized Official Name and Position | Roger J Deshaies (SENOIR VP FINANCE) |
| Authorized Official Contact | 6177327899 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
75 Francis St Boston MA 02115 Ph: (617) 732-6974 | 75 Francis St Boston MA 02115 Ph: (617) 732-6974 |
| NPI Number | 1255308227 |
|---|---|
| Provider Enumeration Date | 03/08/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255308227 | NPI | - | NPPES |
| 1201514 | Medicaid | MA |
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