Individual
DR. EDWARD P WYSOCKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
60 FEDERAL ST, BOSTON, MA 02110-2510
(617) 423-6165
Mailing address
91 WESTLAND AVE, APT 514, BOSTON, MA 02115-3827
(617) 860-8100
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1856668
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/16/2014
Last updated
08/04/2014
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