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Individual

DR. VENU KALLAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
439 BROADWAY, EVERETT, MA 02149-3612
(617) 944-9627
(617) 944-9742
Mailing address
439 BROADWAY, EVERETT, MA 02149-3612
(617) 944-9627

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22210
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
DN22210
MA
Enumeration date
07/03/2008
Last updated
05/12/2025
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