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Individual

DR. ANITHA PRASANNA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
1490 CHENEY HWY, TITUSVILLE, FL 32780
(321) 267-3304
(321) 267-9191
Mailing address
1490 CHENEY HWY, TITUSVILLE, FL 32780
(321) 267-3304
(321) 267-9191

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN16818
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
071202700
FL
Enumeration date
03/14/2007
Last updated
05/20/2021
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