Individual
JACQUELINE ROCHELLE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
45 DIMOCK ST, BOSTON, MA 02119-1208
(612) 442-8800
(617) 442-4088
Mailing address
333 GREAT RIVER RD APT 320, SOMERVILLE, MA 02145-1220
(770) 296-0186
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1859155
MA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/24/2021
Last updated
08/31/2021
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