Individual
KATHLEEN MARY LUISI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
126 AUDUBON AVENUE, BRAINTREE, MA 02184
(617) 913-3321
Mailing address
P.O. BOX 850696, BRAINTREE, MA 02185
(617) 913-3321
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
3466
SC
124Q00000X
Dental Hygienist
Primary
DH11340
MA
Other
Enumeration date
07/28/2010
Last updated
07/28/2010
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