Irina Deresh is a Dental in Boston, Massachusetts. Irina Deresh practices all healthcare services and medical treatments related to Dental. The NPI Number for Irina Deresh is 1821274044. The last update date is 2008-01-17.
Irina Deresh's current location address is 396 Commonwealth Ave, Boston, Massachusetts. You can contact this provider via phone number 6175367720 and fax number 6175368290. The mailing address for Irina Deresh is 396 Commonwealth Ave, Boston, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Irina Deresh |
|---|---|
| Address | 396 Commonwealth Ave, Boston, Massachusetts |
| Phone Number | 6175367720 |
| Fax Number | 6175368290 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Deresh Irina |
| Credentials | DMD |
| Telephone Number | 6175367720 |
NPI Number Detail
| NPI Number | 1821274044 |
|---|---|
| Provider Enumeration Date | 2008-01-17 |
| Last Updated Date | 2008-01-17 |
Provider Mailing Address Detail
| Address | 396 Commonwealth Ave |
|---|---|
| City | Boston |
| State | Massachusetts (MA) |
| Post Code | 22152823 |
| Phone Number | 6175367720 |
| Fax Number | 6175368290 |
Provider's Primary Taxonomy Detail
| Speciality | Dental |
|---|---|
| Taxonomy | 261Qd0000X |
| Licence No | 17846 |
|
Definition: Provides general and specialized dental care and oral surgery. |
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Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Irina Deresh by the Centers for Medicare & Medicaid Services?
The Irina Deresh has been issued the NPI (National Provider Identifier) 1821274044, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Irina Deresh is located?
The Irina Deresh is situated at the following address: 396 Commonwealth Ave, Boston, MA, 22152823.
What is the Irina Deresh's specialty and taxonomy code?
The Irina Deresh's specialty is Dental, and the corresponding taxonomy code is 261Qd0000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1821274044 to Irina Deresh?
The Irina Deresh received its 1821274044 assignment from the Centers for Medicare & Medicaid Services on 2008-01-17.
As of what date were the details related to Irina Deresh most recently updated or revised?
The information pertaining to Irina Deresh, including its address, specialty, and other relevant details, was last updated or revised on 2008-01-17.