Individual
DR. DIVI MITTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 MAIN ST, PEABODY, MA 01960-5509
(978) 238-0309
Mailing address
449 CANAL ST APT 902, SOMERVILLE, MA 02145-4371
(617) 803-0443
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13018
CT
1223G0001X
General Practice Dentistry
39373
TX
1223G0001X
General Practice Dentistry
DN1858489
MA
Other
Enumeration date
10/03/2019
Last updated
04/26/2023
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