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General NPI Number Information
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NPI Number | 1770954240
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Entity Type | Individual
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Provider Name | JASMINE CHOPRA DMD
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Gender | Female
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Dates
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Enumeration Date | 10/09/2015
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Last Update Date | 02/21/2017
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Provider Practice Location Address
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Address Line | 200 HIGH ST
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City | CLINTON
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State | MA
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Zip | 01510-2556
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Country | US
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Telephone | 978-368-0340
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Fax | 978-368-1719
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Provider Business Mailing Address
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Address Line | 650 LINCOLN ST
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City | WORCESTER
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State | MA
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Zip | 01605-2060
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Country | US
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Telephone | 508-532-2200
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Fax | 508-853-8593
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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 | 100121615
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DL1857367
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License Number State | MA
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