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General NPI Number Information
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NPI Number | 1528217783
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Entity Type | Individual
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Provider Name | ALLA SHIKHANOVICH DMD
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Gender | Female
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Dates
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Enumeration Date | 09/11/2008
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Last Update Date | 07/10/2018
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Provider Practice Location Address
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Address Line | 315 MAIN ST STE 101315
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City | READING
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State | MA
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Zip | 01867
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Country | US
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Telephone | 781-944-4450
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Fax | 781-944-4451
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Provider Business Mailing Address
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Address Line | 115 CHARLES ST
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City | READING
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State | MA
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Zip | 01867-1824
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Country | US
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Telephone | 617-331-1726
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22249
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License Number State | MA
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