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1124573456
ESRA M. FADEN
BOSTON, MA
NPI
1124573456
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1223P0300X Dentist, Periodontics
(Licence: ZZ 13-J-D-0030293)
Enumeration Date
2016-08-16
Last Update Date
2016-08-16
Business Address
Miss ESRA M. FADEN
1 KNEELAND ST
BOSTON, MA 02111-1527
Phone number: 617-817-0656
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Mailing Address
Miss ESRA M. FADEN
75 STATION LNDG APT. 526, MEDFORD, MA
MEDFORD, MA 02155-5127
Phone number: 617-817-0656
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