Organization
KIKUKO HIRAYAMA DMD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIKUKO HIRAYAMA DMD (OWNER)
(617) 859-7107
Entity
Organization
Contact information
Practice address
745 BOYLSTON ST, STE 403, BOSTON, MA 02116-2636
(617) 859-7107
Mailing address
745 BOYLSTON ST, STE 403, BOSTON, MA 02116-2636
(617) 859-7107
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
18401
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407956444
NPI TYPE 1
—
Enumeration date
07/31/2014
Last updated
07/31/2014
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