Organization
GUSTAVO PERDOMO DMD PC
Active
Other names
Reliant Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
THIAGO SOARES (ADMINISTRATOR)
(508) 250-6936
Entity
Organization
Contact information
Practice address
1996 CENTRE ST STE 201, WEST ROXBURY, MA 02132-3330
(508) 250-6936
Mailing address
1996 CENTRE ST STE 201, WEST ROXBURY, MA 02132-3330
(508) 250-6936
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/09/2018
Last updated
08/09/2018
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