Individual
DR. GERALD STEPHEN FINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12631
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16001
HPHC
MA
01
—
X04231
BS & MEDICARE
MA
Enumeration date
11/03/2005
Last updated
09/12/2012
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