Individual
MARYAM MANDSAURWALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 BRIDGE ST, LOWELL, MA 01850-1293
(978) 455-7056
Mailing address
1201 BRIDGE ST, LOWELL, MA 01850-1293
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1855042
MA
Other
Enumeration date
04/20/2009
Last updated
08/18/2014
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