Organization
CAMBRIDGE PERIODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK DERKAZARIAN DMD (PERIODONTIST)
(617) 864-5444
Entity
Organization
Contact information
Practice address
1692 MASSACHUSETTS AVE STE 3, CAMBRIDGE, MA 02138
(617) 864-5444
Mailing address
1692 MASSACHUSETTS AVE STE 3, CAMBRIDGE, MA 02138
(617) 864-5444
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
08/02/2019
Last updated
08/02/2019
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