Individual
DR. SHAN LO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
109 BEACH ST, BOSTON, MA 02111-2511
(617) 542-6263
Mailing address
8 GARRISON ST APT 502, BOSTON, MA 02116-5718
(617) 875-0776
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
DN1857001
MA
Other
Enumeration date
09/05/2017
Last updated
09/05/2017
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