Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 21996 | MA |
NPI | 1124213111 |
---|---|
Provider Name | Dr. Mary Elizabeth Guzek |
First Address | Charlestown, MA 02129-3023 |
Second Address | Charlestown, MA 02129-3023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2007 |
Last Update Date | 03/04/2010 |