Organization
COOLIDGE CORNER PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER E DENTON MD (OWNER)
(617) 396-8262
Entity
Organization
Contact information
Practice address
209 HARVARD ST, SUITE 407, BROOKLINE, MA 02446-5071
(617) 396-8262
(617) 396-8261
Mailing address
209 HARVARD ST, SUITE 407, BROOKLINE, MA 02446-5071
(617) 396-8262
(617) 396-8261
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
71501
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71501
LICENSE
MA
Enumeration date
05/01/2013
Last updated
05/01/2013
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