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Individual

EDWARD VANCE GESCHELIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
500 E BROADWAY, SOUTH BOSTON, MA 02127-4406
(617) 268-2333
(617) 268-8894
Mailing address
500 E BROADWAY, SOUTH BOSTON, MA 02127-4406
(617) 268-2333
(617) 268-8894

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10573
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0256897
MA
Enumeration date
06/02/2005
Last updated
02/13/2008
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