Individual
DR. ELLURA REZZA MAE PEPITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
460 FOLEY ST, SOMERVILLE, MA 02145-1213
(857) 300-5779
Mailing address
1621 TREMONT ST, APT 2R, BOSTON, MA 02120-1640
(956) 624-8549
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1857464
MA
Other
Enumeration date
11/13/2016
Last updated
02/28/2019
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