Provider Demographics
NPI:1114146396
Name:KAZIS, KURBAN & ASSOCIATES
Entity Type:Organization
Organization Name:KAZIS, KURBAN & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:CASEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-267-3993
Mailing Address - Street 1:745 BOYLSTON ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-2636
Mailing Address - Country:US
Mailing Address - Phone:617-267-3993
Mailing Address - Fax:617-267-0138
Practice Address - Street 1:745 BOYLSTON ST
Practice Address - Street 2:SUITE 402
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-2636
Practice Address - Country:US
Practice Address - Phone:617-267-3993
Practice Address - Fax:617-267-0138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA155991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty