Individual
DR. CORTINO SUKOTJO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, PH.D
Contact information
Practice address
188 LONGWOOD AVE, BOSTON, MA 02115-5819
(617) 432-1486
(617) 432-0901
Mailing address
188 LONGWOOD AVE, BOSTON, MA 02115-5819
(617) 432-1486
(617) 432-0901
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
9133
MA
Other
Enumeration date
06/14/2007
Last updated
07/08/2007
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