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1104104512
VIKRAM GANUPUR
CLOVIS, NM
NPI
1104104512
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: NM DD3568)
Enumeration Date
2011-08-02
Last Update Date
2011-08-02
Business Address
Dr. VIKRAM GANUPUR
4017 N PRINCE ST
CLOVIS, NM 88101-9705
Phone number: 847-915-3040
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Mailing Address
Dr. VIKRAM GANUPUR
2610 WEDDINGTON RDG NE
MARIETTA, GA 30068-2279
Phone number: 678-923-1486
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