Individual
DR. KEITH RICHARD DOMINICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
750 WASHINGTON ST.-NEMC, #286, BOSTON, MA 02111
(617) 636-5078
Mailing address
11 TELEGRAPH ST. #2, BOSTON, MA 02127
(508) 826-0260
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
229476
MA
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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