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Park Prosthodontics, PLLC

Dentist, Prosthodontics in Boston, MA. Organization (NPI-2).

NPI number1164078655
StatusActive
Last updated in NPPESAug 12, 2019

Details

NPI
1164078655
Entity type
Organization (NPI-2)
Legal business name
Park Prosthodontics, PLLC
Organization subpart
No
Enumeration date
Aug 12, 2019
Last updated
Aug 12, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223P0700X Dentist, Prosthodontics––Yes

Practice location

800 Boylston St Fl 2
Boston, MA 02199-8081

Phone 617-829-9744

Mailing address

776 Main St Unit 540085
Waltham, MA 02454-5405

Phone 203-921-5437

Authorized official

Carly Park
Owner
2039215437

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