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Individual

RONEN MAVASHEV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
55 E BROADWAY UNIT 1, DERRY, NH 03038-2401
(603) 945-1287
Mailing address
55 E BROADWAY UNIT 1, DERRY, NH 03038-2401
(603) 945-1287

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
05159
NH
122300000X
Dentist
110391
CA
122300000X
Dentist
Primary
30.028235
OH

Other

Enumeration date
07/30/2024
Last updated
01/12/2026
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