Organization
GALLERY EYECARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESA DENNIS-MAHAMED O.D. (OPTOMETRIST)
(617) 202-9650
Entity
Organization
Contact information
Practice address
2304 WASHINGTON ST, ROXBURY, MA 02119-3221
(617) 202-9650
(617) 202-9651
Mailing address
2304 WASHINGTON ST, ROXBURY, MA 02119-3221
(617) 202-9650
(617) 202-9651
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4734
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110083858A
—
MA
Enumeration date
11/10/2015
Last updated
11/10/2015
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