Individual
ALA ALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
ONE KNEELAND ST 8 FLOOR, TUFTS DENTAL ASSOCIATE, BOSTON, MA 02111
(617) 636-3496
Mailing address
1 KNEELAND ST OFC 224, BOSTON, MA 02111-1527
(617) 636-3496
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DF 10798
MA
Other
Enumeration date
12/11/2014
Last updated
12/11/2014
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