Healthcare Provider Details

I. General information

NPI: 1851660732
Provider Name (Legal Business Name): REEMA DHINGRA DMD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2011
Last Update Date: 12/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 AUBURN ST
AUBURN MA
01501-2438
US

IV. Provider business mailing address

48 AUBURN ST
AUBURN MA
01501-2438
US

V. Phone/Fax

Practice location:
  • Phone: 508-832-9578
  • Fax:
Mailing address:
  • Phone: 508-832-9578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDN1855139
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN1855139
License Number StateMA

VIII. Authorized Official

Name: REEMA DHINGRA
Title or Position: PRESIDENT
Credential: DMD
Phone: 508-832-9578