Individual
DR. SIDDHARTH GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BDS,MS
Contact information
Practice address
12319 N MOPAC EXPY STE 160, AUSTIN, TX 78758-2648
(512) 222-5721
Mailing address
12319 N MOPAC EXPY STE 160, AUSTIN, TX 78758-2648
(512) 222-5721
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
24143
TX
Other
Enumeration date
08/07/2008
Last updated
07/20/2020
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