Individual
LAURA BANTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1852 CENTRE ST, WEST ROXBURY, MA 02132-1901
(843) 557-4335
Mailing address
178 PUTNAM AVE, CAMBRIDGE, MA 02139-2921
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1856611
MA
Other
Enumeration date
09/02/2014
Last updated
09/02/2014
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