Individual
MALLORY KATHERINE VUKOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
96 N MAIN ST, RANDOLPH, MA 02368-4606
(781) 805-3001
Mailing address
428 W 2ND ST APT 2, BOSTON, MA 02127-1376
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1859459
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/01/2022
Last updated
09/10/2024
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