| |
1 Porter Square Suite 11 Cambridge MA 02140 | |
(617) 547-5665 | |
(617) 864-5666 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 1 Porter Square, Cambridge, Massachusetts |
Authorized Official Name and Position | Michelle Jacomino (DIRECTOR OF PAYOR RELATIONS) |
Authorized Official Contact | 7709165036 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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210 Interstate North Pkwy Se Ste 300 Atlanta GA 30339-2233 Ph: (770) 916-9000 | 1 Porter Square Suite 11 Cambridge MA 02140 Ph: (617) 547-5665 |
NPI Number | 1275620726 |
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Provider Enumeration Date | 10/06/2006 |
Last Update Date | 07/20/2022 |
Identifier | Type | State | Issuer |
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1275620726 | NPI | - | NPPES |
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