Individual
SRIVIDYA PRAKASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD, BDS
Contact information
Practice address
297 UNION AVE, FRAMINGHAM, MA 01702-6378
(508) 709-9268
Mailing address
200 DEER ST APT 2418, MILFORD, MA 01757-5155
(978) 955-1448
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN1860026
MA
Other
Enumeration date
03/09/2023
Last updated
10/16/2023
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