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Individual

BRUNO MONTEIRO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
520 DUDLEY ST, ROXBURY, MA 02119-2769
(617) 989-9499
Mailing address
1 ABBOTSFORD ST, APT. #3, BOSTON, MA 02121-1409
(617) 820-0326

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
097615
BLUE SHIELD
MA
Enumeration date
09/07/2012
Last updated
09/07/2012
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