| NPI | 1356563035 |
|---|---|
| Doing Business As | MOODY STREET DENTAL |
| Entity Type | Organization |
| Authorized Contact | MIKHAIL SHLKINU Dentist Owner 781-894-0889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 20431) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |