Individual
DR. SRISMITHA MODEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
339 SQUIRE RD, SUITE 150, REVERE, MA 02151-4309
(781) 286-7510
Mailing address
339 SQUIRE RD, SUITE 150 DR DENTAL OF REVERE, REVERE, MA 02151
(781) 286-7510
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21334
MA
Other
Enumeration date
01/02/2007
Last updated
08/20/2013
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