Individual
THANARUT TANGKHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
635 ALBANY ST, BOSTON, MA 02118-3550
(617) 358-8300
Mailing address
28 WESTLAND AVE APT 27, BOSTON, MA 02115-3938
(617) 935-2381
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DL15317
MA
Other
Enumeration date
08/26/2022
Last updated
08/26/2022
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