Individual
LINDA PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1443 BEACON ST, BROOKLINE, MA 02446-4707
(617) 232-8222
Mailing address
1443 BEACON ST, BROOKLINE, MA 02446-4707
(617) 232-8222
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN1859046
MA
1223G0001X
General Practice Dentistry
7278
NV
1223P0300X
Periodontics
Primary
DN1859046
MA
Other
Enumeration date
05/25/2018
Last updated
07/16/2024
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