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Organization
TRUSTEES OF TUFTS COLLEGE
Active
Organization
TRUSTEES OF TUFTS COLLEGE
Active
Parent organization
TRUSTEES OF TUFTS COLLEGE
Other names
Tufts Craniofacial Pain Center, Tufts Craniofacial Pain Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRUSTEES OF TUFTS COLLEGE
Authorized official
LEOPOLDO CORREA BDS, MS (PROGRAM DIRECTOR)
(617) 636-3421
Entity
Organization
Contact information
Practice address
1 KNEELAND ST, 6TH FLOOR, BOSTON, MA 02111-1527
(617) 636-6817
(617) 636-3831
Mailing address
1 KNEELAND ST, 6TH FLOOR, BOSTON, MA 02111-1527
(617) 636-6817
(617) 636-3831
Taxonomy
Speciality
Code
Description
License number
State
1223X2210X
Orofacial Pain Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
4105
MA
Other
Enumeration date
03/11/2008
Last updated
04/09/2020
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