Individual
DR. MYLES RICHARD CLANCY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
209 HARVARD ST, BROOKLINE, MA 02446-5071
(617) 731-5437
Mailing address
801 S PAULINA ST, M/C 850, RM 256, CHICAGO, IL 60612-7210
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN1857946
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/27/2016
Last updated
09/12/2018
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