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Organization
SPRINGFIELD PEDIATRIC DENTISTRY
Active
Organization
SPRINGFIELD PEDIATRIC DENTISTRY
Active
Other names
Sirisha Govindaiah DDS, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIRISHA GOVINDAIAH BDS, MPH, DDS (DENTIST/PRESIDENT)
(217) 666-0098
Entity
Organization
Contact information
Practice address
1224 CENTRE WEST DR, SPRINGFIELD, IL 62704-2184
(217) 666-0098
Mailing address
10900 FOX CRST, SAN ANTONIO, TX 78233-7249
(217) 666-0098
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
NULL
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
02/04/2019
Last updated
02/04/2019
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