Individual
MIKHAIL GOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
525 SOUTH BROADWAY, LAWRENCE, MA 01843
(978) 682-0641
(978) 682-0644
Mailing address
525 SOUTH BROADWAY, LAWRENCE, MA 01843
(978) 682-0641
(978) 682-0644
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21083
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0203131
—
MA
Enumeration date
08/05/2006
Last updated
07/27/2015
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