Provider Demographics
NPI:1518398122
Name:DUKA, ADELINA
Entity Type:Individual
Prefix:
First Name:ADELINA
Middle Name:
Last Name:DUKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 BOYLSTON ST
Mailing Address - Street 2:SUITE 501
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-3605
Mailing Address - Country:US
Mailing Address - Phone:617-536-4020
Mailing Address - Fax:
Practice Address - Street 1:551 BOYLSTON ST
Practice Address - Street 2:SUITE 501
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-3605
Practice Address - Country:US
Practice Address - Phone:617-536-4020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-07
Last Update Date:2013-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18563991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice