Individual
PUSHKAR MEHRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
100 E NEWTON STREET, SUITE 407, BOSTON, MA 02118-2308
(617) 638-4350
(617) 638-4365
Mailing address
100 E NEWTON STREET, SUITE 407, BOSTON, MA 02118-2308
(617) 638-4350
(617) 638-4365
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
19862
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0299944
—
MA
01
—
40351BMC
HCHP
MA
01
—
X07996
BCBS
MA
Enumeration date
07/19/2006
Last updated
07/08/2007
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