Gustavo Perdomo Dmd PC

NPI #1578042669 in West Roxbury, Massachusetts

Provider Information

NPI Number: 1578042669
Entity Type: Organization
Organization Name: Gustavo Perdomo Dmd PC
Primary Specialty: Dentist
Enumeration Date: Aug 9, 2018
Last Updated: Aug 9, 2018

Practice Location

Address: 1996 CENTRE ST STE 201
City: West Roxbury
State: Massachusetts
ZIP Code: 02132-3330
Phone: (508) 250-6936

Authorized Official

Name: THIAGO SOARES
Title: ADMINISTRATOR
Phone: (508) 250-6936

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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