Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | DL12973 | MA |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 04647 | NH |
NPI | 1023470184 |
---|---|
Provider Name | Jared Curtin |
First Address | Boston, MA 02118-2308 |
Second Address | Boston, MA 02118-2308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2016 |
Last Update Date | 12/10/2021 |