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Individual
SUDHAKER RAO BALMURI
Active
Individual
SUDHAKER RAO BALMURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17979
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194996645
444 WILLIAMS ST
NJ
01
—
1740345693
741 BROADWAY
NJ
01
—
1932370483
101 LUDLOW
NJ
01
—
1972778413
IRVINGTON
NJ
05
—
6130801
—
NJ
Enumeration date
08/04/2006
Last updated
06/04/2008
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