| Smile Boutique, Pc | |
|
49 Church St Winchester MA 01890-2508 | |
| (781) 729-1444 | |
| (781) 729-1233 |
| Full Name | Smile Boutique, Pc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 49 Church St, Winchester, Massachusetts |
| Authorized Official Name and Position | Mojgan Rahimi (TREASURER) |
| Authorized Official Contact | 7817291444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Boutique, Pc 49 Church St Winchester MA 01890-2508 Ph: (781) 729-1444 | Smile Boutique, Pc 49 Church St Winchester MA 01890-2508 Ph: (781) 729-1444 |
| NPI Number | 1447881339 |
|---|---|
| Provider Enumeration Date | 01/29/2020 |
| Last Update Date | 01/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447881339 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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Thomas D. Russo, D.m.d., P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 63 Shore Rd Ste 13, Winchester, MA 01890 Phone: 781-721-4700 Fax: 781-729-0798 | |
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