| Vijay Gaddam Pc | |
|
43 Sullivan St Springfield MA 01104-2415 | |
| (413) 785-5566 | |
| (413) 785-5568 |
| Full Name | Vijay Gaddam Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 43 Sullivan St, Springfield, Massachusetts |
| Authorized Official Name and Position | Vijay Gaddam (PRESIDENT) |
| Authorized Official Contact | 4137855566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vijay Gaddam Pc 43 Sullivan St Springfield MA 01104-2415 Ph: (413) 785-5566 | Vijay Gaddam Pc 43 Sullivan St Springfield MA 01104-2415 Ph: (413) 785-5566 |
| NPI Number | 1730432162 |
|---|---|
| Provider Enumeration Date | 10/23/2012 |
| Last Update Date | 12/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730432162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 22226 (Massachusetts) | Secondary |
| 1223G0001X | Dentist - General Practice | 010520 (Connecticut) | Primary |
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