Organization
CAMBRIDGE PERIODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK C DERKAZARIAN (PARTNER)
(617) 864-5444
Entity
Organization
Contact information
Practice address
1692 MASSACHUSETTS AVENUE, CAMBRIDGE, MA 02138
(617) 864-5444
(617) 547-0109
Mailing address
1692 MASSACHUSETTS AVENUE, CAMBRIDGE, MA 02138
(617) 864-5444
(617) 547-0109
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
08/09/2006
Last updated
05/03/2012
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