Provider Demographics
NPI:1245608041
Name:SWARUP, DIVYA (DMD)
Entity type:Individual
Prefix:DR
First Name:DIVYA
Middle Name:
Last Name:SWARUP
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 BARRINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-2288
Mailing Address - Country:US
Mailing Address - Phone:617-608-8638
Mailing Address - Fax:
Practice Address - Street 1:65 DRUM HILL RD
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-1503
Practice Address - Country:US
Practice Address - Phone:617-608-8638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-10
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1857051122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist