Individual
HARJEET MUNDRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16 PARK AVE, WORCESTER, MA 01605-3911
(508) 425-7180
(508) 459-8757
Mailing address
16 PARK AVE, WORCESTER, MA 01605-3911
(508) 425-7180
(508) 459-8757
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21183
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0204285
—
MA
05
—
110084296A
—
MA
05
—
1770631087
—
MA
05
—
1811224686
—
MA
Enumeration date
01/05/2007
Last updated
09/19/2013
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