Individual
ANI PESTRIKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CANDIDATE DMD
Contact information
Practice address
1 KNEELAND ST, BOSTON, MA 02111-1527
(617) 636-6828
Mailing address
PO BOX 165, MOUNT TABOR, NJ 07878-0165
(732) 343-2878
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/05/2024
Last updated
04/05/2024
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