Organization
CHILDREN'S DENTAL OF WALTHAM, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YELENA V. GUTNICHENKO D.M.D. (PRESIDENT)
(781) 899-7070
Entity
Organization
Contact information
Practice address
695 MAIN ST, WALTHAM, MA 02451-0609
(781) 899-7070
Mailing address
52 ELM ST, WALTHAM, MA 02453-5317
(781) 899-9530
(781) 736-0977
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/19/2007
Last updated
08/22/2020
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