Organization
RICHARD D CARR DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD D CARR DDS (OWNER)
(617) 262-5880
Entity
Organization
Contact information
Practice address
68 NEW EDGERELY ROAD, BOSTON, MA 02115
(617) 262-5880
(617) 859-8804
Mailing address
68 NEW EDGERELY ROAD, BOSTON, MA 02115
(617) 262-5880
(617) 859-8804
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
11712
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9767703
—
MD
01
—
X10762
BLUE CROSS BLUE SHIELD
MD
Enumeration date
01/24/2007
Last updated
08/22/2020
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