Organization
LEWIS WHARF DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM L. MANESS DDS (OWNER)
(617) 227-4831
Entity
Organization
Contact information
Practice address
28 ATLANTIC AVE., STE. 237, BOSTON, MA 02110
(617) 227-4831
(617) 227-3174
Mailing address
28 ATLANTIC AVE., OFFICE 237, BOSTON, MA 02110
(617) 227-4831
(617) 227-3174
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
11614
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
185821
UNITED CONCORDIA
MA
01
—
X07015
BC/BS
MA
Enumeration date
08/17/2006
Last updated
07/30/2008
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