Individual
MRS. AMY PORTNOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.D.H.
Contact information
Practice address
1400 CENTRE ST, SUITE 201, NEWTON, MA 02459-2454
(617) 965-2440
(617) 965-2423
Mailing address
1400 CENTRE ST, SUITE 201, NEWTON, MA 02459-2454
(617) 965-2440
(617) 965-2423
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
8395
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8395
MA STATE LICENSE #
MA
Enumeration date
11/13/2006
Last updated
07/08/2007
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