Organization
BROOKLINE PERIODENTAL ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARILYN JEAN MENTO (OFFICE MANAGER)
(617) 232-8222
Entity
Organization
Contact information
Practice address
1443 BEACON ST, BROOKLINE, MA 02446-4707
(617) 232-8222
(617) 277-2027
Mailing address
1443 BEACON STREET, BROOKLINE, MA 02446
(617) 232-8222
(617) 277-2027
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
08/30/2006
Last updated
08/22/2020
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