Organization
SHUSTAK DENTAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL ANDREW SHUSTAK D.M.D (OWNER)
(508) 754-7799
Entity
Organization
Contact information
Practice address
255 PARK AVE, SUITE 509, WORCESTER, MA 01609-1953
(508) 754-7799
(508) 754-8558
Mailing address
255 PARK AVE, SUITE 509, WORCESTER, MA 01609-1953
(508) 754-7799
(508) 754-8558
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14677
MA
Other
Enumeration date
04/04/2007
Last updated
07/18/2019
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