| 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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