Individual
DR. AUDRA BUCKLEY REYNOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
100 AMESBURY ST, SUITE 110, LAWRENCE, MA 01840-1321
(978) 686-3838
Mailing address
809 E 4TH ST, UNIT 3, BOSTON, MA 02127-3242
(781) 258-5127
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN1856601
MA
Other
Enumeration date
06/10/2014
Last updated
07/11/2016
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