Healthcare Provider Details

I. General information

NPI: 1245398825
Provider Name (Legal Business Name): HOLBROOK DENTAL ASSOCIATE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 HOLBROOK AVE
NORTH ATTLEBORO MA
02760-2326
US

IV. Provider business mailing address

11 HOLBROOK AVE
NORTH ATTLEBORO MA
02760-2326
US

V. Phone/Fax

Practice location:
  • Phone: 508-695-5800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number20109
License Number StateMA

VIII. Authorized Official

Name: DR. BABAK GOJGINI
Title or Position: OWNER
Credential: DMD
Phone: 508-695-5800