| Cambridge Periodontics | |
|
1692 Massachusetts Avenue Cambridge MA 02138 | |
| (617) 864-5444 | |
| (617) 547-0109 |
| Full Name | Cambridge Periodontics |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1692 Massachusetts Avenue, Cambridge, Massachusetts |
| Authorized Official Name and Position | Mark C Derkazarian (PARTNER) |
| Authorized Official Contact | 6178645444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cambridge Periodontics 1692 Massachusetts Avenue Cambridge MA 02138 Ph: (617) 864-5444 | Cambridge Periodontics 1692 Massachusetts Avenue Cambridge MA 02138 Ph: (617) 864-5444 |
| NPI Number | 1700896164 |
|---|---|
| Provider Enumeration Date | 08/09/2006 |
| Last Update Date | 05/03/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700896164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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