Individual
DIVYA UPADHYAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
614 BLUE HILL AVE, DORCHESTER, MA 02121-3257
(617) 287-0007
Mailing address
614 BLUE HILL AVE, DORCHESTER, MA 02121-3257
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1857112
MA
Other
Enumeration date
02/09/2016
Last updated
02/09/2016
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