Individual
DR. ERIC R GHEEWALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
82 FOREST ST, MEDFORD, MA 02155-3130
(781) 396-1980
(781) 396-4224
Mailing address
82 FOREST ST, MEDFORD, MA 02155-3130
(781) 396-1980
(781) 396-4224
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
18335
MA
Other
Enumeration date
06/28/2005
Last updated
07/08/2007
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