Individual
STANISLAV KOVTUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
185 HARVARD ST, BROOKLINE, MA 02446-5013
(617) 274-8494
Mailing address
25 SHUMAN CIR, NEWTON, MA 02459-2767
(781) 264-2067
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1856247
MA
Other
Enumeration date
05/23/2013
Last updated
10/27/2020
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