# KROTHAPALLI DENTAL GROUP GRANVILLE LLC

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

## Provider details

- **NPI number:** 1700393667
- **Authorized official:** NANARAO KROTHAPALLI (DENTIST)
- **Authorized official phone:** (617) 223-1652

## Contact information

- **Practice address:** 592 NEWARK GRANVILLE RD, GRANVILLE, OH 43023-1436
- **Practice address phone:** (740) 587-1631
- **Mailing address:** 592 NEWARK GRANVILLE RD, GRANVILLE, OH 43023-1436

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/02/2018
- **Last updated:** 01/02/2018