Provider Demographics
NPI:1962567446
Name:MCDEVITT, MARILYN FRANCES (DDS)
Entity type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:FRANCES
Last Name:MCDEVITT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-3654
Mailing Address - Country:US
Mailing Address - Phone:781-828-5742
Mailing Address - Fax:
Practice Address - Street 1:780 BOYLSTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02199-7820
Practice Address - Country:US
Practice Address - Phone:617-424-7138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA157461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice