Provider Demographics
NPI:1427277466
Name:METRI AND BOULOS DENTAL ASSOCIATES
Entity type:Organization
Organization Name:METRI AND BOULOS DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:METRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-335-2250
Mailing Address - Street 1:83 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02188-2313
Mailing Address - Country:US
Mailing Address - Phone:781-335-2250
Mailing Address - Fax:
Practice Address - Street 1:83 BROAD ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02188-2313
Practice Address - Country:US
Practice Address - Phone:781-335-2250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA189841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty