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1497317515
PRASANTH DOMMARAJU
CHICAGO, IL
NPI
1497317515
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IL 019032098)
Enumeration Date
2019-06-29
Last Update Date
2019-06-29
Business Address
Dr. PRASANTH DOMMARAJU DMD
3924 S ARCHER AVE
CHICAGO, IL 60632-1116
Phone number: 773-819-7101
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Mailing Address
Dr. PRASANTH DOMMARAJU DMD
3924 S ARCHER AVE
CHICAGO, IL 60632-1116
Phone number:
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