Organization
BRIGHAM & WOMENS HOSPITAL
Active
Other names
Brigham Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGER J DESHAIES (SENOIR VP FINANCE)
(617) 732-7899
Entity
Organization
Contact information
Practice address
75 FRANCIS ST, BOSTON, MA 02115
(617) 732-6974
(617) 232-8970
Mailing address
75 FRANCIS ST, BOSTON, MA 02115
(617) 732-6974
(617) 232-8970
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1201514
—
MA
Enumeration date
03/08/2006
Last updated
09/11/2025
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