Individual
DR. MIGUEL A ROQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MMSC
Contact information
Practice address
486 WASHINGTON ST LOWR LEVEL, WELLESLEY, MA 02482-5971
(617) 410-8595
Mailing address
486 WASHINGTON ST LOWR LEVEL, WELLESLEY, MA 02482-5971
(617) 410-8595
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DN1857248
MA
1223G0001X
General Practice Dentistry
DN1857248
MA
Other
Enumeration date
06/03/2016
Last updated
12/10/2024
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