Organization
BACK BAY DENTAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD MILLER DMD (PRESIDENT)
(617) 921-6292
Entity
Organization
Contact information
Practice address
21 BAY STATE RD, BOSTON, MA 02215-2101
(617) 247-9966
Mailing address
21 BAY STATE RD, BOSTON, MA 02215-2101
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/29/2012
Last updated
01/03/2013
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