Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DN1856935 | MA |
NPI | 1023456001 |
---|---|
Provider Name | Dr. Helen Fassil |
First Address | Boston, MA 02118-2631 |
Second Address | Framingham, MA 01702-6337 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2013 |
Last Update Date | 16/11/2015 |