Individual
MRS. AGNIESZKA EWA SHANAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
123 NEWTON AVE N, WORCESTER, MA 01609-1403
(774) 239-7205
Mailing address
1116 MAIN ST, HOLDEN, MA 01520-1247
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1855392
MA
Other
Enumeration date
06/18/2010
Last updated
11/02/2010
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