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General NPI Number Information
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NPI Number | 1760120067
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Entity Type | Individual
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Provider Name | RITIKA NANDA
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Gender | Female
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Dates
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Enumeration Date | 05/25/2022
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Last Update Date | 05/25/2022
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Provider Practice Location Address
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Address Line | 171 WATERTOWN ST
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City | WATERTOWN
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State | MA
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Zip | 02472-2699
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Country | US
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Telephone | 617-467-5113
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Fax |
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Provider Business Mailing Address
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Address Line | 16 WOODBINE RD APT 6
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City | NATICK
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State | MA
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Zip | 01760-4064
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Country | US
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Telephone | 781-366-1369
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN1859363
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License Number State | MA
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