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Individual

MRS. SHY CHWEN NI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
188 LONGWOOD AVE, BOSTON, MA 02115-5819
(617) 432-1434
Mailing address
47 HARVARD ST APT A201, BOSTON, MA 02129-3749
(415) 359-6127

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN1858527
MA
390200000X
Student in an Organized Health Care Education/Training Program
MA

Other

Enumeration date
07/17/2019
Last updated
01/08/2020
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