| Convivial Dental Pc | |
|
1244 Boylston St Ste 205 Chestnut Hill MA 02467-2115 | |
| (617) 818-0573 | |
| Not Available |
| Full Name | Convivial Dental Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1244 Boylston St Ste 205, Chestnut Hill, Massachusetts |
| Authorized Official Name and Position | Athanasios Zavras (PRESIDENT) |
| Authorized Official Contact | 6178180573 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Convivial Dental Pc 64 Pine St Dover MA 02030-2426 Ph: () - | Convivial Dental Pc 1244 Boylston St Ste 205 Chestnut Hill MA 02467-2115 Ph: (617) 818-0573 |
| NPI Number | 1689007908 |
|---|---|
| Provider Enumeration Date | 08/11/2013 |
| Last Update Date | 08/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689007908 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | DN1855922 (Massachusetts) | Secondary |
| 261QD0000X | Clinic/center - Dental | DN1855922 (Massachusetts) | Primary |
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