My Dental Warren St

NPI #1578066312 in Roxbury, Massachusetts

Provider Information

NPI Number: 1578066312
Entity Type: Organization
Organization Name: My Dental Warren St
Primary Specialty: Dentist
Enumeration Date: Mar 16, 2018
Last Updated: Mar 16, 2018

Practice Location

Address: 376 WARREN ST
City: Roxbury
State: Massachusetts
ZIP Code: 02119-1830
Phone: (740) 215-8549

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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