Myra J Brennan, DMD

Individual provider Active NPI Prosthodontics · Hingham, MA

NPI 1962652826 · NPPES record last updated Apr 11, 2012

Key facts

NPI
1962652826
Entity type
Individual (NPI type 1)
Primary specialty
Prosthodontics 1223P0700X
License
19902 (MA)
Practice address
24 Shipyard Dr Ste 203
Hingham, MA 02043-1673
Phone
(781) 361-3000
NPI assigned
Sep 26, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
19902MAMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 19902 MA Yes

Addresses

Primary practice location

24 Shipyard Dr Ste 203
Hingham, MA 02043-1673

Mailing address

PO Box 51489
Boston, MA 02205-1489
Phone (781) 361-3000

Other providers in Hingham, MA

All providers in Hingham, MA · Prosthodontics in Massachusetts

Sources for this page

Verify at the official NPI Registry.