Individual
LORENZO TAVELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
114 MOUNT AUBURN ST, CAMBRIDGE, MA 02138-5775
(617) 432-1434
Mailing address
1011 N UNIVERSITY AVE, ANN ARBOR, MI 48109-1078
(734) 604-4364
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DF11762
MA
Other
Enumeration date
12/15/2020
Last updated
11/10/2021
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