Individual
DR. SURESH K NAIDU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
156 DUDLEY ST, ROXBURY, MA 02119
(617) 445-7050
(617) 445-7051
Mailing address
156 DUDLEY ST, ROXBURY, MA 02119
(617) 445-7050
(617) 445-7051
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13632
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0253049
—
MA
01
—
784074
UNITED CONCORDIA
—
01
—
9198817
DORAL
—
01
—
9721738
MEDICAID
MA
01
—
X05064NA
BLUE CROSS BLUE SHIELD MA
MA
Enumeration date
01/26/2007
Last updated
01/30/2008
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