Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 18002 | MA |
NPI | 1073693529 |
---|---|
Provider Name | Dr. Cynthia Tsamtsouris |
First Address | Bedford, MA 01730-1037 |
Second Address | Bedford, MA 01730-1037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 08/07/2007 |