Small, Rena Yvonne
Small, Rena Yvonne is an sole proprietor health care provider with primary practice located at 386 Warren St , Roxbury MA 02119-1830. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Small, Rena Yvonne can be contacted via phone (617) 445-1743.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 15296 | Massachusetts |
Profile Details
| NPI number | 1629241872 |
|---|---|
| LBN Legal business name | Small, Rena Yvonne |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 9th, 2008 |
| Last updated | Apr 9th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629241872 | NPPES |
| Massachusetts | Other | X05804SM | BLUE CROSS OF MA |
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