Individual
NAIJIE GUAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
90 RIVER ST, MATTAPAN, MA 02126-2914
(617) 698-5437
Mailing address
201 W 8TH ST, SUITE 810, PUEBLO, CO 81003-3038
(719) 562-4447
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21170
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0205711
—
MA
Enumeration date
01/08/2007
Last updated
12/28/2010
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