Individual
SUSAN D LO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
10 GOVE ST, EAST BOSTON, MA 02128-1920
(617) 569-5800
(617) 568-4780
Mailing address
10 GOVE ST, EAST BOSTON, MA 02128-1920
(617) 569-5800
(617) 568-4780
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
17369
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0275204
—
MA
Enumeration date
07/18/2006
Last updated
07/08/2007
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