Individual provider · Type 1 NPI
Supontep Teerakanok, DDS
Periodontics · Boston, MA
NPI number
1871134833
Active
Practice location
Henry Goldman School Of Dental Medicine, 635 Albany St
Boston, MA 02118
Mailing address
18 Elba St
Brookline, MA 02446-6759
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Periodontics Primary | 1223P0300X | DL14138 (MA) |
Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
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About NPI 1871134833
Supontep Teerakanok, DDS's National Provider Identifier is 1871134833, issued on Oct 1, 2019. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Boston, MA. The record was last updated on Oct 1, 2019.