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Organization
PRASAD GONAVARUM D.D.S., PROFESSIONAL CORPORATION
Active
Organization
PRASAD GONAVARUM D.D.S., PROFESSIONAL CORPORATION
Active
Other names
Smiles of La Mesa
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRASAD GONAVARUM DDS (PRESIDENT/OWNER)
(630) 788-5833
Entity
Organization
Contact information
Practice address
7122 UNIVERSITY AVE, LA MESA, CA 91942-5926
(619) 698-5471
Mailing address
7122 UNIVERSITY AVE, LA MESA, CA 91942-5926
(619) 698-5471
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/27/2019
Last updated
06/27/2019
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