My Dental Revere PC

NPI #1053765412 in Saugus, Massachusetts

Provider Information

NPI Number: 1053765412
Entity Type: Organization
Organization Name: My Dental Revere PC
Primary Specialty: Dentist
Enumeration Date: Apr 21, 2016
Last Updated: Apr 21, 2016

Practice Location

Address: 1401 ROCK WOOD DR
City: Saugus
State: Massachusetts
ZIP Code: 01906-4537
Phone: (740) 215-8549

Authorized Official

Name: SRINIVAS DESANEEDI, DMD
Title: OWNER
Phone: (740) 215-8549

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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