Organization
TRUSTEES OF BOSTON UNIVERSITY
Active
Other names
Boston University Henry M. Goldman School of Dental Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN HOWARD (SENIOR VP, CFO & TREASURER)
(617) 353-2290
Entity
Organization
Contact information
Practice address
100 E NEWTON ST, RM G317, BOSTON, MA 02118-2308
(617) 638-5932
(617) 638-4490
Mailing address
100 E NEWTON ST, RM G317, BOSTON, MA 02118-2308
(617) 638-5932
(617) 638-4490
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4954
MA
1223E0200X
Endodontics
4954
MA
1223G0001X
General Practice Dentistry
Primary
4954
MA
1223P0106X
Oral and Maxillofacial Pathology Dentistry
4954
MA
1223P0221X
Pediatric Dentistry
4954
MA
1223P0300X
Periodontics
4954
MA
1223P0700X
Prosthodontics
4954
MA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
4954
MA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
4954
MA
124Q00000X
Dental Hygienist
4954
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0242799
—
MA
Enumeration date
01/18/2007
Last updated
12/01/2016
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