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1376215137
POORNIMA MYSORE VISHWANATH
WALTHAM, MA
NPI
1376215137
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: MA DN1859211)
Enumeration Date
2021-09-30
Last Update Date
2021-09-30
Business Address
Dr. POORNIMA MYSORE VISHWANATH DMD
314 MOODY ST
WALTHAM, MA 02453-5202
Phone number: 781-398-0000
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Mailing Address
Dr. POORNIMA MYSORE VISHWANATH DMD
9 FIFER LN
LEXINGTON, MA 02420-1231
Phone number: 512-674-5336
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