Individual
MARIAM LESKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
495 WESTERN AVE, BRIGHTON, MA 02135-1007
(617) 783-0500
Mailing address
144 MOODY ST APT 15-4, WALTHAM, MA 02453-5332
(786) 488-9766
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DL15981
MA
1223D0001X
Public Health Dentistry
DL15981
MA
Other
Enumeration date
02/06/2024
Last updated
03/01/2024
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