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330 Martin Luther King Blvd Boston MA 02119-1868 | |
| (508) 904-1530 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 330 Martin Luther King Blvd, Boston, Massachusetts |
| Authorized Official Name and Position | Mohamad Kamel (OWNER) |
| Authorized Official Contact | 5089041530 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
330 Martin Luther King Blvd Boston MA 02119-1868 Ph: (508) 904-1530 | 330 Martin Luther King Blvd Boston MA 02119-1868 Ph: (508) 904-1530 |
| NPI Number | 1639682305 |
|---|---|
| Provider Enumeration Date | 11/15/2017 |
| Last Update Date | 11/15/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639682305 | NPI | - | NPPES |
| 1841632213 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN1856303 (Massachusetts) | Primary |
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