What is Cortino Sukotjo's NPI number?

The NPI number assigned to this healthcare provider is 1962606640, enumerated as a individual on June 14, 2007.

Where is the provider located?

The provider is located at 188 LONGWOOD AVE BOSTON, MA 02115 and the phone number is (617) 432-1486.

What is the provider's specialty?

The provider's specialty is Dentist with taxonomy code 1223P0700X and a focus in Prosthodontics.

DR. CORTINO SUKOTJO DDS, PH.D - NPI 1962606640

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About Dr. Cortino Sukotjo Dds, Ph.d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CORTINO SUKOTJO DDS, PH.D (NPI 1962606640) is an individual prosthodontics provider in Boston, Massachusetts, licensed in Massachusetts (9133) and active in the NPI registry since June 2007.

NPPES Registry Identity

NPI1962606640

Entity TypeIndividualMale

Primary Taxonomy1223P0700X

Provider Legal NameDR. CORTINO SUKOTJOCredential: DDS, PH.D

Location Address188 LONGWOOD AVEBoston, MA 02115-5819

Mailing Address188 Longwood AveBoston, MA 02115-5819 · (617) 432-1486 · Fax (617) 432-0901

Phone(617) 432-1486

Fax(617) 432-0901

Sole ProprietorYes

Enumeration DateJune 14, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1962606640 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · ProsthodonticsDental Providers

Taxonomy Code1223P0700X

License✔ Licensed in MA · 9133

Definition

That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.

188 LONGWOOD AVE, Boston, MA 02115

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