Organization
METROPOLITAN DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOS KOUMOUTSEAS DMD (DENTIST/ OWNER)
(617) 929-0600
Entity
Organization
Contact information
Practice address
1417 DORCHESTER AVE, DORCHESTER, MA 02122-2915
(617) 929-0600
Mailing address
1417 DORCHESTER AVE, DORCHESTER, MA 02122-2915
(617) 929-0600
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17622
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0277983
—
MA
Enumeration date
04/16/2009
Last updated
04/16/2009
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