Provider Demographics
NPI:1477559052
Name:GRESLA, JANIENE FRANCES (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANIENE
Middle Name:FRANCES
Last Name:GRESLA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-4135
Mailing Address - Country:US
Mailing Address - Phone:781-273-0225
Mailing Address - Fax:781-273-5632
Practice Address - Street 1:120 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-4135
Practice Address - Country:US
Practice Address - Phone:781-273-0225
Practice Address - Fax:781-273-5632
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA196341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice