Provider Demographics
NPI:1669850772
Name:DRS. JOHN H. BOSS AND CHRISTOPHER M. POULOS, LLC
Entity Type:Organization
Organization Name:DRS. JOHN H. BOSS AND CHRISTOPHER M. POULOS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:POULOS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-312-2066
Mailing Address - Street 1:1 RIVER PL
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-1035
Mailing Address - Country:US
Mailing Address - Phone:978-458-1114
Mailing Address - Fax:
Practice Address - Street 1:1 RIVER PL
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1035
Practice Address - Country:US
Practice Address - Phone:978-458-1114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty