Individual
DR. ERISELDA BANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1208B VFW PKWY STE 307, WEST ROXBURY, MA 02132-4350
(617) 325-4100
Mailing address
5 CASS ST APT 7, WEST ROXBURY, MA 02132-4820
(617) 637-5696
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1859615
MA
Other
Enumeration date
12/14/2022
Last updated
12/14/2022
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