| 1555 St Management Group, Inc. | |
|
1555 Main St Suite 203 Tewksbury MA 01876-4741 | |
| (978) 851-5300 | |
| (978) 851-5335 |
| Full Name | 1555 St Management Group, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 1555 Main St, Tewksbury, Massachusetts |
| Authorized Official Name and Position | Sanjayan Thiagarajah (PRESIDENT) |
| Authorized Official Contact | 9788515300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 1555 St Management Group, Inc. 1555 Main St Suite 203 Tewksbury MA 01876-4741 Ph: (978) 851-5300 | 1555 St Management Group, Inc. 1555 Main St Suite 203 Tewksbury MA 01876-4741 Ph: (978) 851-5300 |
| NPI Number | 1326295163 |
|---|---|
| Provider Enumeration Date | 08/22/2008 |
| Last Update Date | 08/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326295163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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