Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DN1858011 | MA |
NPI | 1013376003 |
---|---|
Provider Name | Juliana Ginsberg |
First Address | Boston, MA 02115-5119 |
Second Address | Peabody, MA 01960-2227 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2016 |
Last Update Date | 14/01/2019 |