Philip D Fantasia Jr DDS
NPI #1518151760 in Watertown, Massachusetts
Provider Information
- NPI Number
- 1518151760
- Entity Type
- Organization
- Organization Name
- Philip D Fantasia Jr DDS
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Aug 30, 2007
- Last Updated
- Aug 30, 2007
Practice Location
- Address
- 293 MOUNT AUBURN ST
- City
- Watertown
- State
- Massachusetts
- ZIP Code
- 02472-1955
- Phone
- (617) 923-9446
Authorized Official
- Name
- DR. PHILIP DOMENIC FANTASIA JR., DDS
- Title
- DENTIST
- Phone
- (617) 923-9446
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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