Provider Demographics
NPI:1114188448
Name:GRIFFIN, TERRENCE J (DMD)
Entity Type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:J
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 BOYLSTON ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-2636
Mailing Address - Country:US
Mailing Address - Phone:617-536-4545
Mailing Address - Fax:617-536-4611
Practice Address - Street 1:745 BOYLSTON ST
Practice Address - Street 2:SUITE 206
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-2636
Practice Address - Country:US
Practice Address - Phone:617-536-4545
Practice Address - Fax:617-536-4611
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA121661223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics