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Individual

EDITA OUTERICKA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
1 TECHNOLOGY PARK DR, BOURNE, MA 02532-8336
(508) 759-2724
Mailing address
3 BRADFORD ST, SOUTH EASTON, MA 02375-1453

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
20471
MA

Other

Enumeration date
01/26/2007
Last updated
07/08/2007
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