Grace Jotika Dmd Pc | |
0 Governors Ave Ste 1 Medford MA 02155-3035 | |
(781) 395-5629 | |
Not Available |
Full Name | Grace Jotika Dmd Pc |
---|---|
Speciality | Dentist |
Location | 0 Governors Ave Ste 1, Medford, Massachusetts |
Authorized Official Name and Position | Aupaiporn Grace Jotikabhukkana (OWNER) |
Authorized Official Contact | 6173045019 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Grace Jotika Dmd Pc 0 Governors Ave Ste 1 Medford MA 02155-3035 Ph: () - | Grace Jotika Dmd Pc 0 Governors Ave Ste 1 Medford MA 02155-3035 Ph: (781) 395-5629 |
NPI Number | 1558920298 |
---|---|
Provider Enumeration Date | 06/06/2019 |
Last Update Date | 06/06/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558920298 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
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