# PRAVEENA PETLURI DMD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043862022
- **Authorized official:** PRAVEENA PETLURI (OWNER)
- **Authorized official phone:** (703) 404-9111

## Contact information

- **Practice address:** 46175 WESTLAKE DR STE 220, STERLING, VA 20165-5884
- **Practice address phone:** (703) 404-9111
- **Mailing address:** 46175 WESTLAKE DR STE 220, STERLING, VA 20165-5884

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/10/2019
- **Last updated:** 07/10/2019