Organization
MANOUCH DARVISH DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANOUCH DARVISH (OWNER)
(508) 756-6264
Entity
Organization
Contact information
Practice address
200 LINCOLN STREET, WORCESTER, MA 01605
(508) 756-6264
(508) 756-6490
Mailing address
200 LINCOLN STREET, WORCESTER, MA 01605
(508) 756-6264
(508) 756-6490
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
10534
MA
Other
Enumeration date
06/10/2010
Last updated
06/10/2010
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