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General NPI Number Information
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NPI Number | 1538676085
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Entity Type | Organization
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Legal Business Name | OLGA KRIKUNENKO DMD, LLC
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Dates
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Enumeration Date | 01/05/2018
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Last Update Date | 01/05/2018
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Provider Practice Location Address
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Address Line | 150 EMMONS ST STE 7
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City | FRANKLIN
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State | MA
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Zip | 02038-2036
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Country | US
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Telephone | 508-613-9513
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Fax |
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Provider Business Mailing Address
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Address Line | 101 STOCK FARM RD
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City | SUDBURY
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State | MA
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Zip | 01776-3142
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Country | US
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Telephone | 508-613-9513
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | OLGA KRIKUNENKO
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Credential |
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Telephone | 508-613-9513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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