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1 Kneeland Street 3rd Floor Boston MA 02111 | |
(617) 636-6669 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Dental |
Location | 1 Kneeland Street, Boston, Massachusetts |
Authorized Official Name and Position | Darren J Drag (DIRECTOR OF CLINICAL OPERATIONS) |
Authorized Official Contact | 7818996020 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1 Kneeland Street 3rd Floor Boston MA 02111 Ph: (617) 636-6669 | 1 Kneeland Street 3rd Floor Boston MA 02111 Ph: (617) 636-6669 |
NPI Number | 1720381064 |
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Provider Enumeration Date | 12/08/2010 |
Last Update Date | 12/08/2010 |
Identifier | Type | State | Issuer |
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1720381064 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | 20040 (Massachusetts) | Primary |
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