Provider Demographics
NPI:1144328030
Name:GANDHI, PREETI G (DMD)
Entity type:Individual
Prefix:
First Name:PREETI
Middle Name:G
Last Name:GANDHI
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 1:171 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-5757
Mailing Address - Country:US
Mailing Address - Phone:917-557-4115
Mailing Address - Fax:
Practice Address - Street 1:171 MAPLE ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-5757
Practice Address - Country:US
Practice Address - Phone:917-557-4115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21198122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0207187OtherMASS HEALTH