Provider Demographics
NPI:1962766774
Name:SINGH, PRIYA (DMD)
Entity type:Individual
Prefix:DR
First Name:PRIYA
Middle Name:
Last Name:SINGH
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 1:152 OLD COLONY AVE UNIT 6
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-2450
Mailing Address - Country:US
Mailing Address - Phone:617-306-6656
Mailing Address - Fax:
Practice Address - Street 1:152 OLD COLONY AVE UNIT 6
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-2450
Practice Address - Country:US
Practice Address - Phone:617-306-6656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1856037122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist