| |
274 Newbury St Boston MA 02116-2403 | |
(617) 262-0106 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Dental |
Location | 274 Newbury St, Boston, Massachusetts |
Authorized Official Name and Position | Michael Angelo Scialabba (CHIEF CLINICAL OFFICER) |
Authorized Official Contact | 5615122709 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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200 5th Ave Fl 3 Waltham MA 02451-8759 Ph: (781) 647-0772 | 274 Newbury St Boston MA 02116-2403 Ph: (617) 262-0106 |
NPI Number | 1023387867 |
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Provider Enumeration Date | 12/23/2011 |
Last Update Date | 06/21/2021 |
Identifier | Type | State | Issuer |
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1023387867 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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