PRASANTH DOMMARAJU

CHICAGO, IL
NPI1497317515
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: IL  019032098)
Enumeration Date2019-06-29
Last Update Date2019-06-29
Business Address
Dr. PRASANTH DOMMARAJU DMD
3924 S ARCHER AVE
CHICAGO, IL 60632-1116
Phone number: 773-819-7101
Mailing Address
Dr. PRASANTH DOMMARAJU DMD
3924 S ARCHER AVE
CHICAGO, IL 60632-1116
Phone number: