# OSORIO SOUTH BOSTON DENTAL GROUP DMD PC

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

## Provider details

- **NPI number:** 1568939163
- **Authorized official:** JULIAN OSORIO DMD, MSCD (OWNER/PRESIDENT)
- **Authorized official phone:** (617) 268-1030

## Contact information

- **Practice address:** 9 CHANNEL CTR ST STE 100, BOSTON, MA 02210-3436
- **Practice address phone:** (617) 268-1030
- **Practice address fax:** (617) 268-2924
- **Mailing address:** 9 CHANNEL CTR ST STE 100, BOSTON, MA 02210-3436
- **Mailing address phone:** (617) 268-1030
- **Mailing address fax:** (617) 268-2924

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0700X | Prosthodontics | — | NULL | Yes |
| 1223P0700X | Prosthodontics | — | — | Yes |

## Other

- **Enumeration date:** 11/01/2018
- **Last updated:** 12/11/2024