Individual
DR. DEBORAH ELAINE BETTENCOURT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
360 W BOYLSTON ST, WEST BOYLSTON, MA 01583-2365
(508) 854-0595
Mailing address
6 CALVINS LN, STERLING, MA 01564-2213
(978) 422-7889
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3219
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0354252
—
MA
01
—
151339
HARVARD-PILGRIM
MA
01
—
759099
TUFTS
MA
01
—
W15884
BC/BS
MA
Enumeration date
09/16/2006
Last updated
07/08/2007
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