Individual
LULJETA ISEDISHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1199 BEACON ST, BROOKLINE, MA 02446-5352
(617) 734-8599
Mailing address
131 MAIN ST, QUINCY, MA 02169-6923
(857) 756-2148
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1859212
MA
Other
Enumeration date
09/29/2021
Last updated
09/29/2021
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