Individual
DREW M MITTELMAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1 LYONS ST, DEDHAM, MA 02026-5599
(781) 329-1400
(781) 278-5667
Mailing address
PO BOX 9120, DEDHAM, MA 02027-9120
(781) 329-1400
(781) 278-5667
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12569
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0016778
NEIGHBORHOOD HEALTH PLAN
—
01
—
12569
DELTA DENTAL
—
01
—
X04083
DENTAL BLUE
—
Enumeration date
06/30/2005
Last updated
07/08/2007
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