Organization
DALE M WETMORE DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE MELVIN WETMORE DDS (PRESIDENT)
(617) 536-7168
Entity
Organization
Contact information
Practice address
29 COMMONWEALTH AVENUE, #305, BOSTON, MA 02116
(617) 536-7168
(617) 536-6634
Mailing address
29 COMMONWEALTH AVENUE, #305, BOSTON, MA 02116
(617) 536-7168
(617) 536-6634
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
12755
MA
1223G0001X
General Practice Dentistry
Primary
21163
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X11920
BCBS
MA
Enumeration date
07/26/2006
Last updated
08/22/2020
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