DR. Khara C Gresham, D.M.D

NPI #1790191815 in Mattapan, Massachusetts

Provider Information

NPI Number: 1790191815
Entity Type: Individual
Name: DR. Khara C Gresham, D.M.D
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.M.D
Enumeration Date: Jul 9, 2014
Last Updated: Jul 9, 2014

Practice Location

Address: 1575 BLUE HILL AVE
City: Mattapan
State: Massachusetts
ZIP Code: 02126-2122
Phone: (617) 296-0061

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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