# BHARTHI CHARUGUNDLA DMD PLLC

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

## Provider details

- **NPI number:** 1568912434
- **Authorized official:** DR. BHARATHI CHARUGUNDLA DMD (OWNER)
- **Authorized official phone:** (360) 369-6420

## Contact information

- **Practice address:** 19301 SE 34TH ST, CAMAS, WA 98607-8881
- **Practice address phone:** (360) 369-6420
- **Practice address fax:** (360) 369-4527
- **Mailing address:** 19301 SE 34TH ST, CAMAS, WA 98607-8881
- **Mailing address phone:** (360) 369-6420
- **Mailing address fax:** (360) 369-4527

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | DE60656547 | WA | Yes |

## Other

- **Enumeration date:** 10/04/2016
- **Last updated:** 10/04/2016