Organization
ARCH ST DENTAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EKATRINA MAMULASHVILI D.M.D (OWNER)
(617) 338-7778
Entity
Organization
Contact information
Practice address
103 ARCH ST, BOSTON, MA 02110-1102
(617) 338-7778
(617) 338-7779
Mailing address
103 ARCH ST, BOSTON, MA 02110-1102
(617) 338-7778
(617) 338-7779
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21211
MA
Other
Enumeration date
05/27/2014
Last updated
05/27/2014
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