Organization
BRIAN D BOSTON, DMD, S.C
Active
Other names
Aspen Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIM VAN CAMP (PROVIDER RELATIONS SPECIALIST)
(315) 454-6000
Entity
Organization
Contact information
Practice address
2860 S GREEN BAY RD, SUITE 104, MOUNT PLEASANT, WI 53406-4962
(262) 886-9700
(262) 554-1629
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(866) 273-8204
(866) 803-4943
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/27/2014
Last updated
08/27/2014
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