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1265744189
SRINIVASULU KAKOLLU
BLOOMINGTON, IL
NPI
1265744189
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: IL 019028401)
Enumeration Date
2010-07-08
Last Update Date
2013-03-11
Business Address
Dr. SRINIVASULU KAKOLLU d.d.s
1407 N VETERANS PKWY STE 12
BLOOMINGTON, IL 61704-6425
Phone number: 732-379-0953
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Mailing Address
Dr. SRINIVASULU KAKOLLU d.d.s
1407 N VETERANS PKWY STE 12
BLOOMINGTON, IL 61704-6425
Phone number: 732-379-0953
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