| Rooted Dental Company Pllc | |
|
1371 Beacon St Brookline MA 02446-4905 | |
| (617) 566-2734 | |
| Not Available |
| Full Name | Rooted Dental Company Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1371 Beacon St, Brookline, Massachusetts |
| Authorized Official Name and Position | Khara C Gresham (OWNER) |
| Authorized Official Contact | 4846202192 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rooted Dental Company Pllc 90 Pleasant St Apt 1 Boston MA 02125-4085 Ph: (484) 620-2192 | Rooted Dental Company Pllc 1371 Beacon St Brookline MA 02446-4905 Ph: (617) 566-2734 |
| NPI Number | 1619629177 |
|---|---|
| Provider Enumeration Date | 01/25/2022 |
| Last Update Date | 01/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619629177 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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