Individual
LAKE SEYMOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
188 LONGWOOD AVE, BOSTON, MA 02115-5888
(617) 432-1434
(617) 432-4258
Mailing address
41 SWALLOW ST APT 2, BOSTON, MA 02127-6573
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1859828
MA
Other
Enumeration date
05/19/2023
Last updated
08/03/2023
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