Individual
DR. BORIS STABNIKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
150 SOCIAL ST, SUITE 2, WOONSOCKET, RI 02895-3133
(401) 597-5077
(401) 597-5077
Mailing address
341 S MAIN ST, SHARON, MA 02067-1813
(401) 648-5570
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
19214
MA
1223G0001X
General Practice Dentistry
Primary
DEN02619
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0280283
MASS HEALTH
MA
01
—
8055-2
BLUE CROSS BLUE SHIELD
RI
Enumeration date
03/01/2007
Last updated
07/08/2007
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