# BROOKLINE ORAL SURGERY GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013366525
- **Authorized official:** RICHARD MILLER DMD (PRESIDENT)
- **Authorized official phone:** (617) 921-6292

## Contact information

- **Practice address:** 500 CHAPMAN ST, SUITE 201, CANTON, MA 02021-2093
- **Practice address phone:** (617) 731-6060
- **Mailing address:** 1223 BEACON ST, BROOKLINE, MA 02446-5302
- **Mailing address phone:** (617) 731-6060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 20980 | MA | Yes |

## Other

- **Enumeration date:** 06/06/2016
- **Last updated:** 06/06/2016