Individual
ANDREA PROFETA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
188 LONGWOOD AVE, BOSTON, MA 02115-5819
(617) 432-1434
(617) 432-1434
Mailing address
114 EMERALD ST, MALDEN, MA 02148-6337
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DL13052
MA
Other
Enumeration date
08/30/2016
Last updated
08/30/2016
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