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Individual
SUSMITHA RAO KOTI
Active
Individual
SUSMITHA RAO KOTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
27635
TX
1223G0001X
General Practice Dentistry
DN014164
GA
1223P0221X
Pediatric Dentistry
Primary
D11308
OR
Other
Enumeration date
08/16/2010
Last updated
08/27/2020
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