Individual
SHANKAR RENGASAMY VENUGOPALAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BDS, DDS, DMSC, PHD
Contact information
Practice address
1 KNEELAND ST FL 11, BOSTON, MA 02111-1527
(617) 636-6887
(617) 636-0402
Mailing address
1 KNEELAND ST FL 11, BOSTON, MA 02111-1527
(617) 636-6887
(617) 636-0402
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
40187
IA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN1859679
MA
Other
Enumeration date
07/05/2011
Last updated
02/16/2024
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