Individual
AMY BASTAWROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
26 MARLBOROUGH ST, BOSTON, MA 02116-2157
(617) 266-0441
Mailing address
26 MARLBOROUGH ST, BOSTON, MA 02116-2157
(617) 266-0441
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1856816
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/10/2014
Last updated
02/23/2017
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