Individual
DR. PAUL WALTER PONICHTERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
25 HIGH ST, MILTON, MA 02186-3426
(617) 696-4300
Mailing address
BOX 870061, MILTON, MA 02187-0061
(617) 696-4300
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11595
MA
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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