Individual
DONALD FREDERICK BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
100 E NEWTON ST, G407, BOSTON, MA 02118-2308
(617) 638-4350
(617) 638-4352
Mailing address
100 E NEWTON ST, G407, BOSTON, MA 02118-2308
(617) 638-4350
(617) 638-4365
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9517
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0203505
—
MA
01
—
16396UH
HPHC
—
Enumeration date
08/03/2006
Last updated
07/08/2007
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