Organization
LEXINGTON IMPLANT AND RESTORATIVE DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTA NOEL MANICKAS DMD (OWNER)
(781) 862-8223
Entity
Organization
Contact information
Practice address
803 MASSACHUSETTS AVE, LEXINGTON, MA 02420-3918
(781) 862-8223
Mailing address
803 MASSACHUSETTS AVE, LEXINGTON, MA 02420-3918
(781) 862-8223
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
—
—
Other
Enumeration date
11/19/2018
Last updated
11/19/2018
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