Individual
DR. REEM ANTUN LAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
24 LYMAN ST STE 240, WESTBOROUGH, MA 01581-1483
(508) 366-0122
Mailing address
1005 TRAPELO RD APT 4, WALTHAM, MA 02452-4875
(781) 373-1171
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
20782
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ANX11834
BCBS MS
MA
01
—
MOOX11834
BCBS RI
RI
Enumeration date
10/27/2006
Last updated
07/08/2007
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