| 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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