Male or Other

Dr. Ross U. Icyda D.M.D.

Dentist in Boston, MA(View on Map)

Full Name

Dr. Ross Usa Icyda D.M.D.

NPI Number

1205179421

NPI Type

Individual Provider

Gender

Male

Enumeration Date

04/05/2013

Specialties

(Taxonomies)

Name

Code

122300000X

Primary Taxonomy

Yes

Licenses

State

Florida
Massachusetts
Oregon

License Number

DN 19965
DN1856767
D9790

Contact
Information

Purpose

Mailing
Location

Address

165 CAMBRIDGE ST
165 CAMBRIDGE ST

City

Boston
Boston

State

MA
MA

Postal Code

02114-2750
02114-2783

Country

US
US

Telephone Number

(617) 335-8646
(617) 726-1076

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/19/2016

Provider Address

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