Individual
JAVAD GHOREISHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
77 POND AVE, C103, BROOKLINE, MA 02445-7141
(617) 566-1717
(617) 739-3326
Mailing address
77 POND AVE, C103, BROOKLINE, MA 02445-7141
(617) 566-1717
(617) 739-3326
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18050
MA
Other
Enumeration date
12/19/2006
Last updated
07/08/2007
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