DR. Philip Dominic Fantasia JR., DDS

NPI #1871600023 in Watertown, Massachusetts

Provider Information

NPI Number: 1871600023
Entity Type: Individual
Name: DR. Philip Dominic Fantasia JR., DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Aug 24, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 293 MOUNT AUBURN ST
City: Watertown
State: Massachusetts
ZIP Code: 02472-1955
Phone: (617) 923-9446

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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