Individual
WISSANEE JIA-MAHASAP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS,MS,FACP
Contact information
Practice address
188 LONGWOOD AVE, BOSTON, MA 02115-5819
(617) 432-1434
Mailing address
20 CAMERON ST APT 301, BROOKLINE, MA 02445-7667
(617) 581-8954
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
DF100062
MA
Other
Enumeration date
10/07/2014
Last updated
04/29/2025
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