Individual
VICENTE VERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 KNEELAND ST, BOSTON, MA 02111-1527
(617) 636-6828
Mailing address
1 INDIA ST APT 11A, BOSTON, MA 02109-3309
(857) 328-2880
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
DL15462
MA
390200000X
Student in an Organized Health Care Education/Training Program
DL15462
MA
Other
Enumeration date
03/15/2023
Last updated
03/15/2023
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