Individual
RACHEL MUNGOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
19 TACOMA ST, WORCESTER, MA 01605-3516
(508) 852-1805
(508) 853-8593
Mailing address
19 TACOMA ST, WORCESTER, MA 01605-3516
(508) 852-1805
(508) 853-8593
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
10745
MA
124Q00000X
Dental Hygienist
Primary
DH10745
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1301071
GROUP NUMBER
MA
Enumeration date
04/09/2008
Last updated
12/21/2011
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