Individual
DR. DEVON MARTA PTAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD, MPH
Contact information
Practice address
1 KNEELAND ST FL 11, BOSTON, MA 02111-1527
(810) 305-5305
Mailing address
581 MASSACHUSETTS AVE APT 4, BOSTON, MA 02118-1479
(810) 305-5305
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1858788
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
MA
Other
Enumeration date
06/23/2020
Last updated
01/12/2022
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