Organization
SOMERVILLE FAMILY DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NIKHILESH GORUKANTI DMD (GENERAL DENTIST)
(908) 698-3206
Entity
Organization
Contact information
Practice address
23 BOW ST, 1, SOMERVILLE, MA 02143-2933
(908) 698-3206
Mailing address
23 BOW ST, 1, SOMERVILLE, MA 02143-2933
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1856869
MA
Other
Enumeration date
09/22/2016
Last updated
09/22/2016
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