Individual
DR. NELLIE PATRICIA GANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
850 HARRISON AVE FL 6, BOSTON, MA 02118-4001
(617) 414-4837
Mailing address
46 HEREFORD ST APT 2F, BOSTON, MA 02115-2514
(708) 254-4160
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019.031842
IL
1223G0001X
General Practice Dentistry
Primary
DN1859799
MA
Other
Enumeration date
03/15/2018
Last updated
06/20/2023
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