NPI | 1952548356 |
---|---|
Former Name | SAKUNTHALA CHUKKAPALLI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 26261) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019-027838) |
Enumeration Date | 2009-01-07 |
Last Update Date | 2019-08-14 |