Individual
EKATERINA FEFELOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
285 HANCOCK ST APT 1426, QUINCY, MA 02171-2481
(503) 621-7575
Mailing address
285 HANCOCK ST APT 1426, QUINCY, MA 02171-2481
(503) 621-7575
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN10000433
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/16/2024
Last updated
09/11/2024
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