Organization
RUSSELL STREET DENTAL ASSOCIATES,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT J GAUTHIER JR. DMD (MANAGER)
(508) 791-1777
Entity
Organization
Contact information
Practice address
227 RUSSELL ST, WORCESTER, MA 01602-2126
(508) 791-1777
(508) 792-0244
Mailing address
227 RUSSELL ST, WORCESTER, MA 01602-2126
(508) 791-1777
(508) 792-0244
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/20/2015
Last updated
08/20/2015
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