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50 Staniford St Suite 303 Boston MA 02114-2517 | |
(617) 523-4555 | |
(617) 227-2767 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 50 Staniford St, Boston, Massachusetts |
Authorized Official Name and Position | Terese R. Peters (PRACTICE MANAGER) |
Authorized Official Contact | 6175234555 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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50 Staniford St Suite 303 Boston MA 02114-2517 Ph: (617) 523-4555 | 50 Staniford St Suite 303 Boston MA 02114-2517 Ph: (617) 523-4555 |
NPI Number | 1629277694 |
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Provider Enumeration Date | 07/11/2007 |
Last Update Date | 07/11/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629277694 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 11308 (Massachusetts) | Primary |
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