Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 15467 | MA |
NPI | 1356368229 |
---|---|
Provider Name | Dr. Jonathan Stuart Bamel |
First Address | Newton, MA 02459 |
Second Address | North Highlands, MA 02461 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 08/07/2007 |