RUSTAM K. DE VITRE DMD NPI 1457577884

NPI Information

RUSTAM K. DE VITRE, DMD is a prosthodontics dentist in Boston, MA. The provider is that branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. RUSTAM K. DE VITRE, DMD NPI is 1457577884. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

392 COMMONWEALTH AVE
BOSTON, MA
ZIP 02215
Phone: (617) 236-5969
Fax: (617) 424-6298

The provider's authorized official is Rustam K De Vitre .
The authorized official title is Owner and has the following contact phone number (617) 236-5969.

The enumeration date for this NPI number is 4/17/2007 and was last updated on 8/27/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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