Organization
WESTON PEDIATRIC DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REEM ANTUN LAGO DMD (DENTIST/OWNER)
(781) 893-3003
Entity
Organization
Contact information
Practice address
450 BOSTON POST RD, WESTON, MA 02493-1529
(781) 893-3003
Mailing address
450 BOSTON POST RD, WESTON, MA 02493-1529
(781) 893-3003
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
MA
1223P0221X
Pediatric Dentistry
18840
MA
1223P0221X
Pediatric Dentistry
Primary
20782
MA
Other
Enumeration date
09/16/2010
Last updated
09/16/2010
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