Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 21582 | MA |
NPI | 1003081316 |
---|---|
Provider Name | Armida Dano |
First Address | Revere, MA 02151-2600 |
Second Address | Boston, MA 02118-1201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2008 |
Last Update Date | 28/04/2008 |