Organization
MASS CHILDREN HEALTHY SMILES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN M LUISI R.D.H. (PUBLIC HEALTH DENTAL HYGIENIST)
(617) 913-3321
Entity
Organization
Contact information
Practice address
19 GREEN LEAF RD, BRIDGEWATER, MA 02324-2154
(508) 979-0373
Mailing address
19 GREEN LEAF RD, BRIDGEWATER, MA 02324-2154
(508) 979-0373
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
DH10126
MA
124Q00000X
Dental Hygienist
Primary
DH11340
MA
Other
Enumeration date
11/18/2010
Last updated
11/18/2010
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