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Organization

HARVARD SCHOOL OF DENTAL MEDICINE

Active
Parent organization
HARVARD SCHOOL OF DENTAL MEDICINE
Organization subpart
Yes

Provider details

NPI number
Legal business name
HARVARD SCHOOL OF DENTAL MEDICINE
Authorized official
MRS. CATHERINE R LANE (ASSISTANT DEAN CLINICAL OPERATIONS)
(617) 432-4276
Entity
Organization

Contact information

Practice address
188 LONGWOOD AVE, BOSTON, MA 02115-5819
(617) 515-9993
Mailing address
188 LONGWOOD AVE, BOSTON, MA 02115-5819
(617) 515-9993

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DL11500
MA

Other

Enumeration date
04/09/2012
Last updated
04/09/2012
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