Individual
DR. CHRISTOPHER FANELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
15 PARKMAN ST, BOSTON, MA 02114-3117
(617) 726-2000
Mailing address
1470 LEXINGTON SQ SW, VERO BEACH, FL 32962-3412
(617) 513-9709
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN1858568
MA
390200000X
Student in an Organized Health Care Education/Training Program
DRP1445
FL
Other
Enumeration date
08/12/2015
Last updated
07/19/2020
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