Individual
DR. MICHAEL MOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7 FOSTER ST, SUITE 1, REVERE, MA 02151-3419
(781) 289-3200
(781) 289-3200
Mailing address
7 FOSTER ST, SUITE 1, REVERE, MA 02151-3419
(781) 289-3200
(781) 289-3200
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11122
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0225894
—
MA
01
—
X03814
BLUE CROSS BLUE SHIELD
—
Enumeration date
01/02/2007
Last updated
07/08/2007
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