Provider Demographics
NPI:1043879836
Name:SAI SMILE CENTER PLLC
Entity Type:Organization
Organization Name:SAI SMILE CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MANJULA
Authorized Official - Middle Name:
Authorized Official - Last Name:BATTALURI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-339-3446
Mailing Address - Street 1:2 JACK RABBIT LN
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-6804
Mailing Address - Country:US
Mailing Address - Phone:617-320-9858
Mailing Address - Fax:
Practice Address - Street 1:325 AYER RD
Practice Address - Street 2:
Practice Address - City:HARVARD
Practice Address - State:MA
Practice Address - Zip Code:01451-1132
Practice Address - Country:US
Practice Address - Phone:978-772-6658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA201260Medicaid