| The Practice Of Anesthesia & Gen. Dentistry | |
|
386 A/b Warren Street Roxbury MA 02119-0000 | |
| (800) 676-2750 | |
| Not Available |
| Full Name | The Practice Of Anesthesia & Gen. Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 386 A/b Warren Street, Roxbury, Massachusetts |
| Authorized Official Name and Position | Lue Dee Jackson (GEN. DENTIST & ANESTHESIOLOGIST/OWN) |
| Authorized Official Contact | 8006762750 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Practice Of Anesthesia & Gen. Dentistry 18 Claremont Park Boston MA 02118-3002 Ph: (800) 676-2750 | The Practice Of Anesthesia & Gen. Dentistry 386 A/b Warren Street Roxbury MA 02119-0000 Ph: (800) 676-2750 |
| NPI Number | 1417128042 |
|---|---|
| Provider Enumeration Date | 03/24/2008 |
| Last Update Date | 03/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417128042 | NPI | - | NPPES |
| 0262331 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 15374 (Massachusetts) | Primary |
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