Individual
JONATHAN FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
409 W BROADWAY, SOUTH BOSTON, MA 02127-2245
(617) 464-5825
Mailing address
701 PARK AVE, DENTAL & ORAL SURGERY CLINIC, PURPLE BUILDING, LEVEL 7, MINNEAPOLIS, MN 55415-1623
(612) 873-3000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1857869
MA
Other
Enumeration date
04/04/2017
Last updated
08/15/2018
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