Provider Demographics
NPI:1073090692
Name:GREATER BOSTON WELLNESS PRIMARY CARE PC
Entity Type:Organization
Organization Name:GREATER BOSTON WELLNESS PRIMARY CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:TEEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-326-1464
Mailing Address - Street 1:246 WALNUT ST STE 104
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02460-1639
Mailing Address - Country:US
Mailing Address - Phone:617-244-3322
Mailing Address - Fax:
Practice Address - Street 1:200 PROVIDENCE HWY
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-1881
Practice Address - Country:US
Practice Address - Phone:781-461-0660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-26
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Single Specialty