JASON LANIER OUTLAW

BOSTON, MA
NPI1184144651
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: MA  DN1858198)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2017-06-26
Last Update Date2020-05-06
Business Address
Dr. JASON LANIER OUTLAW DMD, DMSc
1575 BLUE HILL AVE
BOSTON, MA 02126-2122
Phone number: 617-296-0061
Mailing Address
Dr. JASON LANIER OUTLAW DMD, DMSc
25 DORCHESTER AVE #51237
BOSTON, MA 02205
Phone number: 312-731-5818