Individual
ALLA AGAMOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
47 POND ST UNIT 3, SHARON, MA 02067-2044
(781) 784-8435
(784) 784-6598
Mailing address
267 HARTMAN RD, NEWTON, MA 02459-2815
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
20247
MA
1223G0001X
General Practice Dentistry
Primary
20247
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA1084778C
MSCR
MA
Enumeration date
04/16/2007
Last updated
05/25/2021
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