Individual
MARVA KHALID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
70 WESTGATE DR, BROCKTON, MA 02301
(781) 854-1757
Mailing address
8 HARVEY LN, NORTH EASTON, MA 02356-1386
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1858071
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/17/2018
Last updated
08/15/2018
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