Provider Demographics
NPI:1568936458
Name:DR.RAMYA SURESH DMD PC
Entity Type:Organization
Organization Name:DR.RAMYA SURESH DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMYA
Authorized Official - Middle Name:KANNAN
Authorized Official - Last Name:SURESH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-944-0589
Mailing Address - Street 1:162 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TOWNSEND
Mailing Address - State:MA
Mailing Address - Zip Code:01469-1038
Mailing Address - Country:US
Mailing Address - Phone:978-597-8909
Mailing Address - Fax:
Practice Address - Street 1:162 MAIN ST
Practice Address - Street 2:
Practice Address - City:TOWNSEND
Practice Address - State:MA
Practice Address - Zip Code:01469-1038
Practice Address - Country:US
Practice Address - Phone:978-597-8909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty