Individual
DR. LISA CAMPANELLA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
55 FRUIT STREET CPZ 401, MASSACHUSETTS GENERAL HOSPITAL, BOSTON, MA 02114
(671) 726-1076
(617) 724-6681
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
19450
MA
Other
Enumeration date
11/30/2005
Last updated
07/08/2007
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