Individual
MISS JEANINE RENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DENTAL HYGIENIST RDH
Contact information
Practice address
1425 BLUE HILL AVE, MATTAPAN, MA 02126-2253
(617) 296-0061
Mailing address
47 CONCORD AVE, MILTON, MA 02186-1116
(617) 449-8610
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
13617
MA
Other
Enumeration date
10/31/2007
Last updated
10/31/2007
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