Oral Medicine | |
1 Kneeland St Oral Medicine Dept. Room 508 Boston MA 02111-1527 | |
(617) 636-3932 | |
(617) 636-4083 |
Full Name | Oral Medicine |
---|---|
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 |
---|---|
Oral Medicine 1 Kneeland St Oral Medicine Dept. Room 508 Boston MA 02111-1527 Ph: (617) 636-3932 | Oral Medicine 1 Kneeland St Oral Medicine Dept. Room 508 Boston MA 02111-1527 Ph: (617) 636-3932 |
NPI Number | 1861605123 |
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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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