Individual
NIKHILESH RAO GORUKANTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
594 CENTRE ST APT 1, JAMAICA PLAIN, MA 02130-2560
(617) 522-8005
Mailing address
231 HARRISON AVE APT 16, BOSTON, MA 02111-1857
(908) 698-3206
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1856869
MA
Other
Enumeration date
05/06/2015
Last updated
05/19/2015
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