Individual
DR. BENJAMIN LICKTEIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
870 PROVIDENCE HWY, DEDHAM, MA 02026-6806
(781) 329-0067
(781) 320-5603
Mailing address
870 PROVIDENCE HWY, DEDHAM, MA 02026-6806
(781) 329-0067
(781) 320-5603
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4782
MA
Other
Enumeration date
10/21/2009
Last updated
12/06/2012
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