Organization
BELMONT PERIODONTICS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANA BINA (BUSINESS MANAGER)
(617) 484-0475
Entity
Organization
Contact information
Practice address
18 MOORE ST, SUITE 300, BELMONT, MA 02478-2525
(617) 484-0475
Mailing address
18 MOORE ST, SUITE 300, BELMONT, MA 02478-2525
(617) 484-0475
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
15531
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15531
DENTAL LICENSE
MA
Enumeration date
05/31/2006
Last updated
08/22/2020
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