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1 Kneeland St Oral Medicine Dept. Room 508 Boston MA 02111-1527 | |
| (617) 636-3932 | |
| (617) 636-4083 |
| Full Name | |
|---|---|
| Speciality | Dentist - Dental Public Health |
| Location | 1 Kneeland St, Boston, Massachusetts |
| Authorized Official Name and Position | Athena S Papas (PROFESSOR) |
| Authorized Official Contact | 6176363932 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1 Kneeland St Oral Medicine Dept. Room 508 Boston MA 02111-1527 Ph: (617) 636-3932 | 1 Kneeland St Oral Medicine Dept. Room 508 Boston MA 02111-1527 Ph: (617) 636-3932 |
| NPI Number | 1861605123 |
|---|---|
| Provider Enumeration Date | 05/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861605123 | NPI | - | NPPES |
| 1165 | Other | MA | DENTAL LICENSE |
| 4105 | Other | MA | DENTAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | 1165 (Massachusetts) | Primary |
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