Ivory Dental PC
NPI #1770902090 in Southbridge, Massachusetts
Provider Information
- NPI Number
- 1770902090
- Entity Type
- Organization
- Organization Name
- Ivory Dental PC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Apr 15, 2014
- Last Updated
- Apr 15, 2014
Practice Location
- Address
- 176 MAIN ST
- Address 2
- UNIT #210
- City
- Southbridge
- State
- Massachusetts
- ZIP Code
- 01550-2561
- Phone
- (908) 955-3699
Authorized Official
- Name
- DR. SUSHMA REDDY DONTHI REDDY, D.M.D
- Title
- PRESIDENT
- Phone
- (908) 955-3699
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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