Organization
AESTHETIC SERVICES INC.
Active
Other names
Dream Spa Medical, DREAM SPA MEDICAL INC.
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA BROUILLARD (OWNER)
(617) 906-8115
Entity
Organization
Contact information
Practice address
1340 BEACON ST, BROOKLINE, MA 02446-3201
(617) 906-8115
Mailing address
1340 BEACON ST, BROOKLINE, MA 02446-3201
(617) 906-8115
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
PRIVATE PRACTICE
—
Enumeration date
11/25/2020
Last updated
11/25/2020
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