Organization
ELITE DENTAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SATHISH L GOBICHETTYPALAYAM DDS (PRESIDENT)
(781) 698-7136
Entity
Organization
Contact information
Practice address
76 SOUTH ST, BROCKTON, MA 02301-6841
(508) 583-1772
(508) 560-5616
Mailing address
76 SOUTH ST, BROCKTON, MA 02301-6841
(508) 583-1772
(508) 560-5616
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22099
MA
Other
Enumeration date
12/22/2015
Last updated
12/22/2015
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