Individual
DR. JAY MURUGA THEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
200 WESTGATE DR STE 119, BROCKTON, MA 02301-1810
(508) 583-3840
Mailing address
200 WESTGATE DR STE 119, BROCKTON, MA 02301-1810
(508) 583-3840
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1855979
MA
Other
Enumeration date
06/04/2012
Last updated
06/04/2012
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