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NPI Code Detail

MEDICARE: MARYAM MANDSAURWALA

MEDICARE: MARYAM MANDSAURWALA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDN1855042MA

General Provider Information

NPI Number : 1700029824
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARYAM MANDSAURWALA
Provider Business Mailing Address
First Line : 1201 BRIDGE ST
Second Line :
City : LOWELL
State : MA
Zip : 01850-1293
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1201 BRIDGE ST
Second Line :
City : LOWELL
State : MA
Zip : 01850-1293
Country : US
Telephone Number : 978-455-7056
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2009
Last Update Date : 08/18/2014

Similar Medicare Providers

1881308310 — LOWELL DENTISTRY AND BRACES, PC
Practice Location Address:
1201 BRIDGE ST
LOWELL, MA
01850-1293
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1427567783 — MARYAM MAGHSOUDLOO
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1700476371 — PRIYAL SHAH
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1201 BRIDGE ST
LOWELL, MA
01850-1293
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Practice Fax:
1164007811 — DR. CATALINA OSSES ALBORNOZ DDS
Practice Location Address:
1201 BRIDGE ST
LOWELL, MA
01850-1293
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Practice Fax:
1366136905 — MADISON CELESTE DALLMEYER DMD
Practice Location Address:
1201 BRIDGE ST
LOWELL, MA
01850-1293
Practice Phone: 978-455-7056
Practice Fax:

Directions to “ MARYAM MANDSAURWALA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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