Organization
GRACE JOTIKA DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AUPAIPORN GRACE JOTIKABHUKKANA DMD (OWNER)
(617) 304-5019
Entity
Organization
Contact information
Practice address
0 GOVERNORS AVE STE 1, MEDFORD, MA 02155-3035
(781) 395-5629
Mailing address
0 GOVERNORS AVE STE 1, MEDFORD, MA 02155-3035
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
06/06/2019
Last updated
06/06/2019
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