Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DN1856664 | MA |
NPI | 1003224270 |
---|---|
Provider Name | Daimery Heinstein |
First Address | Boston, MA 02116-2403 |
Second Address | Boston, MA 02116-2403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2014 |
Last Update Date | 31/07/2014 |