Organization
SRI DENTAL ARTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SRISMITHA MODEM (DMD)
(617) 784-3133
Entity
Organization
Contact information
Practice address
1811 CENTRE ST, WEST ROXBURY DENTAL ARTS, W ROXBURY, MA 02132
(617) 323-0800
Mailing address
1811 CENTRE ST, WEST ROXBURY DENTAL ARTS, W ROXBURY, MA 02132
(617) 323-0800
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN21334
MA
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
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