Individual
DR. MAYA MUTHUSWAMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
612 CENTRE ST, JAMAICA PLAIN, MA 02130-2552
(617) 524-4400
Mailing address
200 WESTGATE DR STE 2, BROCKTON, MA 02301-1810
(508) 587-5333
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
20507
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02973999
—
MA
Enumeration date
10/03/2006
Last updated
06/19/2008
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