Individual
JUAN MANUEL REYES VARGAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1852 CENTRE ST, BOSTON, MA 02132-1901
(617) 934-2951
Mailing address
691 MASSACHUSETTS AVE UNIT 106, BOSTON, MA 02118-4078
(407) 751-9214
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1859618
MA
1223G0001X
General Practice Dentistry
DN1859618
MA
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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