Provider Demographics
NPI:1518131101
Name:JANIENE GRESLA, D.D.S.,P.C.
Entity type:Organization
Organization Name:JANIENE GRESLA, D.D.S.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANIENE
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:GRESLA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:781-273-0225
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19634261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental