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Individual

DR. ERICK FERNANDO GOMEZ MARROQUIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
ONE KNEELAND ST, ROOM 416, BOSTON, MA 02111
(617) 636-6814
Mailing address
34 CAMBRIDGE STREET, APARTMENT 2211, CHARLESTOWN, MA 02129
(860) 515-9228

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DF11773
MA
122300000X
Dentist
Primary
DF11888
MA
1223X2210X
Orofacial Pain Dentistry
DN23854
FL

Other

Enumeration date
07/11/2016
Last updated
10/28/2022
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