| No | |
|
127 Eastern Ave Gloucester MA 01930-1802 | |
| (978) 546-3821 | |
| (978) 546-3821 |
| Full Name | No |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 127 Eastern Ave, Gloucester, Massachusetts |
| Authorized Official Name and Position | Sergey Zemlyansky (DENTIST) |
| Authorized Official Contact | 9785463821 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| No 127 Eastern Ave Gloucester MA 01930-1802 Ph: (978) 546-3821 | No 127 Eastern Ave Gloucester MA 01930-1802 Ph: (978) 546-3821 |
| NPI Number | 1295995280 |
|---|---|
| Provider Enumeration Date | 06/12/2008 |
| Last Update Date | 06/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295995280 | NPI | - | NPPES |
| V05039 | Other | MA | BLUE CROSS AND BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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