Organization
BOSTON DENTAL RESTORATIVE GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXANDER RENE SCHROTT DMD, MMSC (MANAGING DIRECTOR)
(617) 227-4924
Entity
Organization
Contact information
Practice address
25 NEW CHARDON ST, SUITE 102, BOSTON, MA 02114-4774
(617) 227-4924
(617) 227-1824
Mailing address
25 NEW CHARDON ST, SUITE 102, BOSTON, MA 02114-4774
(617) 227-4924
(617) 227-1824
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
Other
Enumeration date
04/13/2015
Last updated
04/13/2015
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