Individual
DIANE A. SUDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
200 SPRINGS RD, BEDFORD VETERANS AFFAIRS MEDICAL CENTER, DENTAL, BEDFORD, MA 01730-1114
(781) 687-2000
Mailing address
200 SPRINGS RD, BEDFORD VETERANS AFFAIRS MEDICAL CENTER, DENTAL, BEDFORD, MA 01730-1114
(781) 687-2000
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
15653
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH148
HARVARD PILGRIM
MA
01
—
V06040
BCBS - DENTAL
MA
Enumeration date
03/16/2006
Last updated
08/08/2015
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