Individual
DR. ROSS USA ICYDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
165 CAMBRIDGE ST, SUITE 401, BOSTON, MA 02114-2783
(617) 726-1076
Mailing address
165 CAMBRIDGE ST, STE 401, BOSTON, MA 02114-2750
(617) 335-8646
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D9790
OR
122300000X
Dentist
DN 19965
FL
122300000X
Dentist
Primary
DN1856767
MA
Other
Enumeration date
04/05/2013
Last updated
08/19/2016
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