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Individual

ANNIE GENG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
1290 TREMONT ST, ROXBURY, MA 02120-3432
(617) 427-1000
Mailing address
64 HEMENWAY ST APT 27, BOSTON, MA 02115-2918
(857) 654-2655

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1857667
MA
390200000X
Student in an Organized Health Care Education/Training Program
MA

Other

Enumeration date
06/01/2017
Last updated
03/07/2018
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