Organization
DR.DENTAL OF REVERE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RENEE P MCKAIN (MANAGER)
(781) 420-9920
Entity
Organization
Contact information
Practice address
339 SQUIRE RD, SUITE 150, REVERE, MA 02151-4309
(781) 286-7510
(781) 286-7513
Mailing address
339 SQUIRE RD, SUITE 150, REVERE, MA 02151-4309
(781) 286-7510
(781) 286-7513
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN20485
MA
Other
Enumeration date
12/08/2011
Last updated
12/08/2011
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