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Individual
LAKSHMI MITREYI GORUGANTULA
Active
Individual
LAKSHMI MITREYI GORUGANTULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
32505
TX
1223X0008X
Oral and Maxillofacial Radiology Dentistry
32505
TX
125Q00000X
Oral Medicine Dentistry
32505
TX
Other
Enumeration date
04/09/2014
Last updated
11/11/2016
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