| Elite Dental Group Pc | |
|
76 South St Brockton MA 02301-6841 | |
| (508) 583-1772 | |
| (508) 560-5616 |
| Full Name | Elite Dental Group Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 76 South St, Brockton, Massachusetts |
| Authorized Official Name and Position | Sathish L Gobichettypalayam (PRESIDENT) |
| Authorized Official Contact | 7816987136 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Dental Group Pc 76 South St Brockton MA 02301-6841 Ph: (508) 583-1772 | Elite Dental Group Pc 76 South St Brockton MA 02301-6841 Ph: (508) 583-1772 |
| NPI Number | 1811352537 |
|---|---|
| Provider Enumeration Date | 12/22/2015 |
| Last Update Date | 12/22/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811352537 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 22099 (Massachusetts) | Primary |
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