NPI | 1316091184 |
---|---|
Doing Business As | PARK AVENUE DENTAL CENTER |
Entity Type | Organization |
Authorized Contact | GOKULAN THIAGARAJAH President 508-485-1114 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 18683) |
Enumeration Date | 2007-01-22 |
Last Update Date | 2022-06-29 |