| My Dentist, Llc | |
|
1297 Beacon St Brookline MA 02446-5242 | |
| (617) 566-1524 | |
| (617) 566-1514 |
| Full Name | My Dentist, Llc |
|---|---|
| Speciality | Dentist |
| Location | 1297 Beacon St, Brookline, Massachusetts |
| Authorized Official Name and Position | Igor Alexis Lozada (OWNER) |
| Authorized Official Contact | 6175661524 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| My Dentist, Llc 1297 Beacon St Brookline MA 02446-5242 Ph: (617) 566-1524 | My Dentist, Llc 1297 Beacon St Brookline MA 02446-5242 Ph: (617) 566-1524 |
| NPI Number | 1679594543 |
|---|---|
| Provider Enumeration Date | 07/23/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679594543 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 20430 (Massachusetts) | Primary |
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