Individual
DR. BHOOMI KOTAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
60 EAST ST STE 2500, METHUEN, MA 01844-4519
(978) 788-9303
(978) 237-4003
Mailing address
320 MIDDLESEX AVE UNIT C208, MEDFORD, MA 02155-5084
(603) 930-1124
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019031413
IL
122300000X
Dentist
DN1857832
MA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN1857832
MA
Other
Enumeration date
09/26/2017
Last updated
03/25/2025
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