Individual
DR. GORAN IVAN BENIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DR.MED.DENT.
Contact information
Practice address
188 LONGWOOD AVE, BOSTON, MA 02115-5819
(617) 401-1340
Mailing address
188 LONGWOOD AVE, BOSTON, MA 02115-5819
(617) 401-1340
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10521
MA
Other
Enumeration date
04/07/2009
Last updated
04/07/2009
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