Individual
PRAEWVANIT ASAVANAMUANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 KNEELAND ST, BOSTON, MA 02111-1527
(617) 636-3915
Mailing address
8 WINTER ST UNIT 304, BOSTON, MA 02108-4735
(213) 543-8264
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DL15322
MA
Other
Enumeration date
08/16/2022
Last updated
08/16/2022
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