Southbridge Dental LLC
NPI #1184284549 in Southbridge, Massachusetts
Provider Information
- NPI Number
- 1184284549
- Entity Type
- Organization
- Organization Name
- Southbridge Dental LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jun 18, 2019
- Last Updated
- Sep 20, 2021
Practice Location
- Address
- 305 MAIN ST
- City
- Southbridge
- State
- Massachusetts
- ZIP Code
- 01550-3726
- Phone
- (508) 765-0880
Authorized Official
- Name
- DR. SUMAN REDDIVARI, DMD
- Title
- MEMBER
- Phone
- (781) 552-1567
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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