Individual
IVY ELIZABETH PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
303 MAIN ST STE 1A, WORCESTER, MA 01608-1538
(508) 425-4787
Mailing address
303 MAIN ST STE 1A, WORCESTER, MA 01608-1538
(508) 425-4787
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DN1856734
MA
Other
Enumeration date
06/10/2014
Last updated
10/15/2025
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