Individual
VIKKI LOUISE NOONAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D., D.M.SC.
Contact information
Practice address
133 BROOKLINE AVE, 6TH FLOOR;HARVARD VANGUARD MEDICAL ASSOC.;DEPT OF PATH., BOSTON, MA 02215-3904
(617) 421-2844
(617) 421-2423
Mailing address
133 BROOKLINE AVE, 6TH FLOOR;HARVARD VANGUARD MEDICAL ASSOC.;DEPT OF PATH., BOSTON, MA 02215-3904
(617) 421-2844
(617) 421-2423
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
19519
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0203718
—
MA
01
—
AA27554
HARVARD PILGRIM
—
01
—
X09107
BLUE CROSS
—
Enumeration date
08/13/2006
Last updated
03/20/2025
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