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Individual

DR. KHARA C GRESHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.M.D

Contact information

Practice address
1575 BLUE HILL AVE, MATTAPAN, MA 02126-2122
(617) 296-0061
Mailing address
1575 BLUE HILL AVE, MATTAPAN, MA 02126-2122
(617) 296-0061

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1856586
MA

Other

Enumeration date
07/09/2014
Last updated
07/09/2014
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