Individual
DR. HERSHEL T ELLENBOGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
98 CHURCH ST, WHITINSVILLE, MA 01588-1416
(508) 234-5073
Mailing address
98 CHURCH ST, WHITINSVILLE, MA 01588-1416
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19110
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X11549
BLUE CROSS
MA
Enumeration date
06/23/2005
Last updated
07/08/2007
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