My Dental Llc | |
314 Moody St Suite B Waltham MA 02453-5202 | |
(740) 215-8549 | |
Not Available |
Full Name | My Dental Llc |
---|---|
Speciality | Clinic/center - Dental |
Location | 314 Moody St, Waltham, Massachusetts |
Authorized Official Name and Position | Srinivas Desaneedi (DENTIST) |
Authorized Official Contact | 7402158549 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
My Dental Llc 184 Kennedy Dr Apt 10 Malden MA 02148-3402 Ph: (740) 215-8549 | My Dental Llc 314 Moody St Suite B Waltham MA 02453-5202 Ph: (740) 215-8549 |
NPI Number | 1366722100 |
---|---|
Provider Enumeration Date | 08/24/2011 |
Last Update Date | 08/24/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366722100 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | 22184 (Massachusetts) | Primary |
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