Organization
POONAM SOI DMD LLC
Active
Other names
376 Dental Studio
Organization subpart
No
Provider details
NPI number
Authorized official
POONAM SOI DMD (OWNER/GENERAL DENTIST)
(206) 949-7622
Entity
Organization
Contact information
Practice address
376 MOODY ST, WALTHAM, MA 02453-5204
(206) 949-7622
Mailing address
160 CAMBRIDGEPARK DRIVE APT 359, CAMBRIDGE, MA 02140
(206) 949-7622
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1856498
MA
Other
Enumeration date
07/18/2017
Last updated
07/18/2017
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