| My Dental Warren St | |
|
376 Warren St Roxbury MA 02119-1830 | |
| (740) 215-8549 | |
| Not Available |
| Full Name | My Dental Warren St |
|---|---|
| Speciality | Dentist |
| Location | 376 Warren St, Roxbury, 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 Warren St 20 Balancing Rock Rd Canton MA 02021-4230 Ph: (740) 215-8549 | My Dental Warren St 376 Warren St Roxbury MA 02119-1830 Ph: (740) 215-8549 |
| NPI Number | 1578066312 |
|---|---|
| Provider Enumeration Date | 03/16/2018 |
| Last Update Date | 03/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578066312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN22184 (Massachusetts) | Primary |
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