Organization
PARK SQUARE DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSHMA REDDY DONTHI REDDY DMD (PRESIDENT)
(908) 955-3699
Entity
Organization
Contact information
Practice address
60 COURT ST, WESTFIELD, MA 01085-3509
(908) 955-3699
Mailing address
60 COURT ST, WESTFIELD, MA 01085
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1855451
MA
Other
Enumeration date
05/09/2016
Last updated
05/09/2016
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