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Dr. Myles Richard Clancy, DMD
Student in an Organized Health Care Education/Training Program in Brookline, Massachusetts
NPI 1922456276

Myles Richard Clancy is a Student in an Organized Health Care Education/Training Program based in Chicago, MA. Myles Richard Clancy practices in Brookline, MA and has the professional credentials of DMD. The NPI Number for Myles Richard Clancy is 1922456276 and holds a License No. DN1857946 (Massachusetts).

The current practice location address for Myles Richard Clancy is 209 Harvard St, Brookline, MA and can be reached out via phone at 617-731-5437. You can also correspond with Myles Richard Clancy through the mailing address at 801 S PAULINA ST, CHICAGO, IL - 60612-7210 (mailing address contact number: ).

Location: 209 Harvard St, Brookline, MA, 60612-7210
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1922456276
Provider Name
Myles Richard Clancy
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
209 Harvard St, Brookline, MA, 60612-7210
Phone Number
617-731-5437
Fax Number
Provider Enumeration Date
05/27/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
209 Harvard St
City
Brookline
State
Massachusetts
Zip
02446-5071
Phone Number
617-731-5437
Fax Number
person
Provider Business Mailing Address Details
Address
801 S Paulina St
City
Chicago
State
Illinois
Zip
60612-7210
Phone Number
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
()
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
DN1857946 (Massachusetts)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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