| |
800 Boylston St Fl 2 Boston MA 02199-1900 | |
(617) 721-6188 | |
Not Available |
Full Name | |
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Speciality | Dentist - Prosthodontics |
Location | 800 Boylston St Fl 2, Boston, Massachusetts |
Authorized Official Name and Position | Kumiko Kamachi (TREASURER) |
Authorized Official Contact | 6177216188 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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27 Pier 7 Charlestown MA 02129-4226 Ph: (617) 721-6188 | 800 Boylston St Fl 2 Boston MA 02199-1900 Ph: (617) 721-6188 |
NPI Number | 1235656984 |
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Provider Enumeration Date | 08/24/2017 |
Last Update Date | 11/04/2021 |
Identifier | Type | State | Issuer |
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1235656984 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0700X | Dentist - Prosthodontics | DN20426 (Massachusetts) | Primary |
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