Individual
BENJAMIN CANARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
188 LONGWOOD AVENUE, HARVARD SCHOOL OF DENTAL MEDICINE, BOSTON, MA 02115
(203) 313-3454
Mailing address
314B LANGLEY ROAD, NEWTON, MA 02459
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN1856943
MA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN1856943
MA
390200000X
Student in an Organized Health Care Education/Training Program
DN1856943
MA
Other
Enumeration date
07/13/2015
Last updated
07/13/2017
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