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Individual

MICHELLE VO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
1353 DORCHESTER AVE, DORCHESTER, MA 02122-2932
(617) 740-2277
Mailing address
1353 DORCHESTER AVE, DORCHESTER, MA 02122-2932

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DN1856416
MA
1223P0221X
Pediatric Dentistry
Primary
DN1856416
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110022129
MA
Enumeration date
10/31/2013
Last updated
07/22/2020
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