Individual
KYEREMAA BAMPO ADDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
32 CONCORD ST, FRAMINGHAM, MA 01702-8302
(508) 270-2635
Mailing address
28A BOSTON AVE, WORCESTER, MA 01604-1948
(508) 459-9060
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH87654
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110022061E
MEDICAID GROUP NUMBER
MA
Enumeration date
11/17/2011
Last updated
11/17/2011
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