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Individual

SANGEETHA RAGHAVENDRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
391 MONTGOMERY ST, CHICOPEE, MA 01020-1929
(413) 592-8099
(413) 592-5839
Mailing address
391 MONTGOMERY ST, CHICOPEE, MA 01020-1929
(413) 592-8099
(413) 592-5839

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
21113
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1426492
UNITED CONCORDIA
CA
01
X11395
BCBS MA
MA
Enumeration date
04/03/2007
Last updated
07/08/2007
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