Individual
WALEERAT KAWEEVISALTRAKUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 E NEWTON ST # G219, BOSTON, MA 02118-2308
(617) 638-5429
Mailing address
1575 TREMONT ST APT 912, ROXBURY CROSSING, MA 02120-1634
(617) 318-8152
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
10427
MA
Other
Enumeration date
10/08/2008
Last updated
10/08/2008
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