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General NPI Number Information
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NPI Number | 1558087742
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Entity Type | Organization
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Legal Business Name | SAMVEL MARTIROSYAN DMD INC
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Dates
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Enumeration Date | 10/18/2022
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | 164 GALEN ST
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City | WATERTOWN
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State | MA
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Zip | 02472-4524
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Country | US
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Telephone | 617-699-6333
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Fax |
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Provider Business Mailing Address
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Address Line | 68 MILL BROOK AVE
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City | WALPOLE
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State | MA
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Zip | 02081-2163
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAMVEL MARTIROSYAN
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Credential | DMD
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Telephone | 617-699-6333
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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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