Individual
SUSANA TEJADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
45 DIMOCK ST, ROXBURY, MA 02119-1208
(617) 442-8800
(617) 442-4088
Mailing address
379A CENTRE ST, JAMAICA PLAIN, MA 02130-1241
(617) 553-4838
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1855592
MA
Other
Enumeration date
11/19/2010
Last updated
04/13/2020
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