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General NPI Number Information
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NPI Number | 1932760311
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Entity Type | Individual
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Provider Name | SWAITHA S MARIPURI DMD
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Gender | Female
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Dates
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Enumeration Date | 06/26/2019
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Last Update Date | 06/26/2019
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Provider Practice Location Address
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Address Line | 380 MERRIMACK ST
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City | METHUEN
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State | MA
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Zip | 01844-5870
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Country | US
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Telephone | 978-681-7740
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Fax |
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Provider Business Mailing Address
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Address Line | 41 UPTON ST APT 1
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City | BOSTON
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State | MA
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Zip | 02118-1609
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Country | US
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Telephone | 603-479-7929
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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 | DN1858315
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License Number State | MA
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