Organization
BOSTON ORAL AND FACIAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK KIU TAO CHAN D.M.D. (OWNER)
(617) 451-2111
Entity
Organization
Contact information
Practice address
120 LINCOLN ST, BOSTON, MA 02111-2506
(617) 451-2111
Mailing address
120 LINCOLN ST, BOSTON, MA 02111-2506
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
09/18/2008
Last updated
01/10/2009
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