Individual
DR. EKATERINA BAGAEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
500 SOUTH ST W, RAYNHAM, MA 02767-5342
(718) 503-1406
Mailing address
8828 75TH AVE, GLENDALE, NY 11385-7926
(718) 503-1406
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1858400
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Enumeration date
05/11/2018
Last updated
08/05/2019
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