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Organization
IRINA DERESH
Active
Organization
IRINA DERESH
Active
Other names
TMD and Periodontal Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRINA DERESH DMD (PRESIDENT)
(617) 536-7720
Entity
Organization
Contact information
Practice address
396 COMMONWEALTH AVE, BOSTON, MA 02215-2823
(617) 536-7720
(617) 536-8290
Mailing address
396 COMMONWEALTH AVE, BOSTON, MA 02215-2823
(617) 536-7720
(617) 536-8290
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
17846
MA
Other
Enumeration date
01/17/2008
Last updated
01/17/2008
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