Provider Demographics
NPI:1902942345
Name:RAMAN, SREE (DMD)
Entity Type:Individual
Prefix:
First Name:SREE
Middle Name:
Last Name:RAMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-2421
Mailing Address - Country:US
Mailing Address - Phone:603-669-6131
Mailing Address - Fax:866-634-2456
Practice Address - Street 1:222 RIVER RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-2421
Practice Address - Country:US
Practice Address - Phone:603-669-6131
Practice Address - Fax:866-634-2456
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA216181223G0001X
NH03617122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice