Organization
FIRST IMPRESSION DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DMITRY GRIGORY MERZON DMD (OWNER)
(617) 207-8667
Entity
Organization
Contact information
Practice address
1751 MASSACHUSETTS AVE FL 1, CAMBRIDGE, MA 02140-2218
(617) 207-8667
Mailing address
1751 MASSACHUSETTS AVE FL 1, CAMBRIDGE, MA 02140-2218
(617) 207-8667
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
1258907
MA
Other
Enumeration date
01/08/2016
Last updated
01/26/2016
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