Individual
JESUS ANTONIO MENDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
18 HAVILAND ST APT 33, BOSTON, MA 02115-2651
(786) 521-5494
Mailing address
18 HAVILAND ST APT 33, BOSTON, MA 02115-2651
(786) 521-5494
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1859478
MA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/16/2022
Last updated
07/13/2022
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