| Tufts Phdh Program | |
|
200 Harrison Ave Fl 2 Boston MA 02111 | |
| (617) 636-4021 | |
| Not Available |
| Full Name | Tufts Phdh Program |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 200 Harrison Ave Fl 2, Boston, Massachusetts |
| Authorized Official Name and Position | Lisa Gately (MANAGER) |
| Authorized Official Contact | 6176366505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tufts Phdh Program 200 Harrison Ave Fl 2 Boston MA 02111-1836 Ph: (617) 636-4021 | Tufts Phdh Program 200 Harrison Ave Fl 2 Boston MA 02111 Ph: (617) 636-4021 |
| NPI Number | 1811490790 |
|---|---|
| Provider Enumeration Date | 03/16/2018 |
| Last Update Date | 06/06/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811490790 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | DH0032PDO (Massachusetts) | Secondary |
| 261QD0000X | Clinic/center - Dental | () | Primary |
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