Individual
DR. SANJEEVAN VIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
5 MIDDLESEX AVE, SUITE 305, SOMERVILLE, MA 02145-1102
(617) 764-1781
(617) 764-5649
Mailing address
PO BOX 231118, BOSTON, MA 02123-1118
(510) 789-7557
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1855058
MA
1223G0001X
General Practice Dentistry
57983
CA
Other
Enumeration date
12/29/2008
Last updated
02/19/2013
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