Individual
DR. RUSTAM K DE VITRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
392 COMMONWEALTH AVE, BOSTON, MA 02215-2801
(617) 236-5969
(617) 424-6265
Mailing address
392 COMMONWEALTH AVE, BOSTON, MA 02215-2801
(617) 236-5969
(617) 424-6265
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
13701
MA
Other
Enumeration date
01/02/2007
Last updated
07/08/2007
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