Organization
MY DENTAL SOUTHBRIDGE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SRINIVAS DESANEEDI DMD (OWNER)
(740) 215-8549
Entity
Organization
Contact information
Practice address
305 MAIN ST, SOUTHBRIDGE, MA 01550-3726
(508) 765-0880
Mailing address
20 BALANCING ROCK RD, CANTON, MA 02021-4230
(740) 215-8549
(508) 300-1275
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/30/2023
Last updated
08/30/2023
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