| Fenway Health | |
|
1340 Boylston St Boston MA 02215-4302 | |
| (617) 927-6127 | |
| Not Available |
| Full Name | Fenway Health |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1340 Boylston St, Boston, Massachusetts |
| Authorized Official Name and Position | Kara Roberts (OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 6179276479 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fenway Health 1340 Boylston Street Boston MA 02215 Ph: (617) 927-6127 | Fenway Health 1340 Boylston St Boston MA 02215-4302 Ph: (617) 927-6127 |
| NPI Number | 1124259056 |
|---|---|
| Provider Enumeration Date | 07/27/2009 |
| Last Update Date | 07/27/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124259056 | NPI | - | NPPES |
| 110020739B | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
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