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Individual

DR. KURTIS LEE WADSWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
1 KNEELAND ST, BOSTON, MA 02111-1527
(617) 636-6889
Mailing address
1 KNEELAND ST, BOSTON, MA 02111-1527
(617) 636-6889

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DS038709
PA

Other

Enumeration date
11/05/2011
Last updated
11/05/2011
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