SRIDHAR MEDA

SOUTH BEND, IN
NPI1225264054
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: IN  12011708)
Additional Taxonomies1223G0001X Dentist, General Practice
(Licence: MA  DN1855074)
Enumeration Date2009-06-08
Last Update Date2012-10-12
Business Address
Dr. SRIDHAR MEDA DMD
1005 EAST LASALLE AVE
SOUTH BEND, IN 46617
Phone number: 574-245-7504
Mailing Address
Dr. SRIDHAR MEDA DMD
14983 FAIRFIELD DR
GRANGER, IN 46530
Phone number: