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Individual

DR. PAOLO JUNIOR FANTOZZI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
75 FRANCIS ST, BOSTON, MA 02115-6110
(617) 732-6570
Mailing address
1620 TREMONT ST STE BC-3028, BOSTON, MA 02120-1613
(617) 732-6570

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DL13898
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
FNTPJN90R19B114V
MA
Enumeration date
02/20/2019
Last updated
02/20/2019
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