Provider Demographics
NPI:1316051675
Name:GRANOVSKY, SVETA (DMD)
Entity type:Individual
Prefix:DR
First Name:SVETA
Middle Name:
Last Name:GRANOVSKY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 WASHINGTON ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-1859
Mailing Address - Country:US
Mailing Address - Phone:781-329-4545
Mailing Address - Fax:781-407-0585
Practice Address - Street 1:347 WASHINGTON ST
Practice Address - Street 2:SUITE 302
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-1859
Practice Address - Country:US
Practice Address - Phone:781-329-4545
Practice Address - Fax:781-407-0585
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18734122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist