Organization
DORCHESTER HOUSE MULTI SERVICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIAQI TAO (CFO)
(617) 288-3230
Entity
Organization
Contact information
Practice address
1353 DORCHESTER AVE, DORCHESTER, MA 02122-2932
(617) 288-3230
Mailing address
1353 DORCHESTER AVE, DORCHESTER, MA 02122-2932
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578514733
NPI
MA
Enumeration date
01/02/2008
Last updated
01/02/2008
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