MEDICARE: JINAL VORA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	122300000X	Dentist	DN1858131	MA

General Provider Information

NPI Number	:	1083199129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JINAL VORA

Provider Business Mailing Address
First Line	:	220 RESERVOIR ST STE 9
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02494-3133
Country	:	US
Telephone Number	:	781-400-5920
Fax Number	:	617-863-2036

Provider Business Practice Location Address
First Line	:	222 E MAIN ST
Second Line	:
City	:	MARLBOROUGH
State	:	MA
Zip	:	01752-2690
Country	:	US
Telephone Number	:	508-305-2766
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2018
Last Update Date	:	10/05/2018

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Directions to “ JINAL VORA ” Practice Location

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