Individual
GUSTAVO ERNESTO MAHN ARTEAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1 KNEELAND ST, BOSTON, MA 02111-1527
(617) 636-0861
Mailing address
1 KNEELAND ST, BOSTON, MA 02111-1527
(617) 636-0861
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
DF11658
MA
390200000X
Student in an Organized Health Care Education/Training Program
151165
NC
Other
Enumeration date
09/01/2017
Last updated
02/04/2021
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