IRINA DERESH NPI 1821274044

NPI Information

IRINA DERESH is a dental clinic center in Boston, MA. IRINA DERESH NPI is 1821274044. The provider is registered as an organization entity type.
The provider Is Doing Business As Tmd And Periodontal Associates.

The provider's business location address is:

396 COMMONWEALTH AVE
BOSTON, MA
ZIP 02215-823
Phone: (617) 536-7720
Fax: (617) 536-8290

The provider's authorized official is Irina Deresh .
The authorized official title is President and has the following contact phone number (617) 536-7720.

The enumeration date for this NPI number is 1/17/2008 and was last updated on 1/17/2008.

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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