Individual
KSENIA SUNDUKOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
30 COLLEGE AVE, SOMERVILLE, MA 02144-1914
(617) 764-2247
Mailing address
100 STOCKTON ST APT 201, CHELSEA, MA 02150-2259
(347) 320-5653
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1860063
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/06/2023
Last updated
06/04/2024
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