Organization
PARK PROSTHODONTICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLY PARK DMD (OWNER)
(203) 921-5437
Entity
Organization
Contact information
Practice address
800 BOYLSTON ST FL 2, BOSTON, MA 02199-8081
(617) 829-9744
Mailing address
776 MAIN ST UNIT 540085, WALTHAM, MA 02454-5405
(203) 921-5437
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
—
—
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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