Individual
ALLA VANINOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
102 2ND AVE, NEEDHAM, MA 02494-2809
(617) 304-9531
Mailing address
89 BULLARD ST, SHARON, MA 02067-1007
(617) 543-7535
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
MA
174400000X
Specialist
Primary
—
—
Other
Enumeration date
03/14/2024
Last updated
03/14/2024
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