Organization
BROOKLINE ORAL SURGERY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD MILLER DMD (PRESIDENT)
(617) 921-6292
Entity
Organization
Contact information
Practice address
500 CHAPMAN ST, SUITE 201, CANTON, MA 02021-2093
(617) 731-6060
Mailing address
1223 BEACON ST, BROOKLINE, MA 02446-5302
(617) 731-6060
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
20980
MA
Other
Enumeration date
06/06/2016
Last updated
06/06/2016
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