Gomer, Mikhail
Gomer, Mikhail is an individual health care provider with primary practice located at 525 South Broadway , Lawrence MA 01843. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Gomer, Mikhail can be contacted via phone (978) 682-0641.Contact Information
Primary practice address
525 South Broadway
Lawrence MA 01843
Phone: (978) 682-0641
Fax: (978) 682-0644
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 21083 | Massachusetts |
Profile Details
| NPI number | 1649289802 |
|---|---|
| LBN Legal business name | Gomer, Mikhail |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 5th, 2006 |
| Last updated | Jul 27th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649289802 | NPPES |
| Massachusetts | MEDICAID | 0203131 |
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