Organization
NORTH ACTON DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PADMA NANDURI JONNAVITHULA DMD (OWNER)
(978) 266-1614
Entity
Organization
Contact information
Practice address
255 GREAT RD, ACTON, MA 01720-4739
(978) 266-1614
Mailing address
255 GREAT RD, ACTON, MA 01720-4739
(978) 266-1614
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19346
MA
Other
Enumeration date
08/02/2011
Last updated
08/02/2011
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