Provider Demographics
NPI:1376267591
Name:NOROC LLC
Entity Type:Organization
Organization Name:NOROC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MINNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KACHKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-640-0915
Mailing Address - Street 1:1223 BEACON ST STE C
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5332
Mailing Address - Country:US
Mailing Address - Phone:781-640-0915
Mailing Address - Fax:
Practice Address - Street 1:1223 BEACON ST STE C
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5332
Practice Address - Country:US
Practice Address - Phone:781-640-0915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1578976890OtherNPI NUMBER