| NPI | 1265580237 |
|---|---|
| Doing Business As | STAR SMILE |
| Entity Type | Organization |
| Authorized Contact | KATHRYN ALEXANDRA POLYAKOV Dentist/Owner 508-872-0045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MA 19569) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 20584) |
| 1223P0300X Dentist, Periodontics (Licence: MA 13973) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2024-05-06 |