Individual
GI HUH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1037A BEACON ST, BROOKLINE, MA 02446-5609
(617) 232-1515
Mailing address
471 MASSACHUSETTS AVE APT 5-2, BOSTON, MA 02118-1173
(318) 780-4379
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN10000395
MA
Other
Enumeration date
03/06/2023
Last updated
10/14/2024
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