Organization
DR.SUJATHA LAKSHMI REVUR,DMD,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUJATHA LAKSHMI REVUR D.M.D (FAMILY DENTIST)
(508) 393-3029
Entity
Organization
Contact information
Practice address
221 BOSTON POST RD E, SUITE 440, MARLBOROUGH, MA 01752-3527
(508) 485-8812
Mailing address
36 VALENTINE RD, NORTHBOROUGH, MA 01532-1337
(508) 393-3029
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19824
MA
Other
Enumeration date
12/31/2007
Last updated
12/31/2007
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