Individual
EDWARD VANISKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
77 S BEDFORD ST, SUITE 100, BURLINGTON, MA 01803-5115
(781) 272-0800
Mailing address
77 S BEDFORD ST STE 100, BURLINGTON, MA 01803-5154
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN22199
MA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS030512L
PA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DN22199
MA
Other
Enumeration date
12/14/2005
Last updated
05/09/2019
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