Provider Demographics
NPI:1518039973
Name:DORITY, KRISTEN CHOE (DMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:CHOE
Last Name:DORITY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 BOYLSTON ST
Mailing Address - Street 2:SUITE 1040
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-4618
Mailing Address - Country:US
Mailing Address - Phone:617-426-5549
Mailing Address - Fax:617-426-1186
Practice Address - Street 1:100 BOYLSTON ST
Practice Address - Street 2:SUITE 1040
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-4618
Practice Address - Country:US
Practice Address - Phone:617-426-5549
Practice Address - Fax:617-426-1186
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA205951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice