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Organization
LEXINGTON IMPLANT AND RESTORATIVE DENTISTRY
Active
Organization
LEXINGTON IMPLANT AND RESTORATIVE DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTA NOEL MANICKAS DMD (OWNER)
(781) 862-8223
Entity
Organization
Contact information
Practice address
803 MASSACHUSETTS AVE, LEXINGTON, MA 02420-3918
(781) 862-8223
Mailing address
803 MASSACHUSETTS AVE, LEXINGTON, MA 02420-3918
(781) 862-8223
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
—
—
Other
Enumeration date
11/19/2018
Last updated
11/19/2018
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